LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
1
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
"THE COMPANY"
A T AND T PLAN
A. COPELAND ENTERPRISES INC
A-G ADMINISTRATORS
A-1 SERVICE COMPREHENSIVE HEALTH INSURANCE
AAA COOPER (SELF INSURED)
AAA LIFE INSURANCE COMPANY
AAG BENEFITS
AARP
AARP HEALTH CARE OPTIONS
AARP-UNITED HEALTHCARE
AAU USA SPORTS
ABB VETCO GRAY (SELF FUNDED) INC
ABBOTT LABORATORIES HEALTH PLAN
ABI ADMINISTRATIVE SER.
ABRAZO ADVANTAGE HEALTH PLAN
2282-00
1566-00
1511-00
2535-00
1271-00
1312-00
0001-00
3237-00
3763-00
0522-00
3612-00
3702-00
2928-00
1186-00
1299-00
H598-50
LAGUNA HILLS
SHREVEPORT
JEFFERSON
VALLEY FORGE
JEFFERSON
DOTHAN
FAIRFAX
DALLAS
PHILADELPHIA
ATLANTA
ATLANTA
BRIGHTON
LAFAYETTE
CHICAGO
MINNETONKA
PHOENIX
CA
LA
LA
PA
LA
AL
VA
TX
PA
GA
GA
ME
LA
IL
MN
AR
92654
71118
70121
19482
70121
36302
22033
75261
19187
30374
30374
04009
70562
60690
55343
85020
ACACIA MUTUAL LIFE INSURANCE COMPANY
ACADEMY LIFE INSURANCE COMPANY
ACADIA BENEFIT OF THE SOUTH INC
ACADIAN HEALTH CARE ALLIANCE
ACBL MEDICARE SUPPLEMENT
ACCELERATION LIFE INSURANCE COMPANY
0003-00
0004-00
2232-00
2859-00
0788-00
1514-00
WASHINGTON
VALLEY FORGE
DELUTH
LAFAYETTE
DES MOINES
MONROE
DC
PA
GA
LA
IA
LA
20001
19487
30136
70505
50398
71201
ACCESS INSURANCE COMPANY
ACCREDITED TRUST LIFE INSURANCE COMPANY
ACMG
ACOG GROUP INSURANCE PLANS
ACORDIA BENEFITS OF FLORIDA
ACORDIA LOCAL GOVERNMENT BENEFITS IINC
ACORDIA NATIONAL
ACORDIA OF LEXINGTON INC
ACORDIA OF MISSISSIPPI
ACORDIA SMALL BUSINESS BENEFITS OF THE SOUTHWEST INC
3213-00
0005-00
2041-00
1129-00
2337-00
2097-00
2506-00
2733-00
2701-00
2165-00
LAFAYETTE
PHOENIX
MIAMISBURG
CHICAGO
W PALM BEACH
INDIANAPOLIS
CHARLESTON
LEXINGTON
RIDGELAND
CORPUS CHRISTI
LA
AZ
OH
IL
FL
IN
WV
KY
MS
TX
70508
85016
45342
60601
23401
46268
25332
40583
39158
78411
ACS BENEFITS SERVICES
3101-00
DALLAS
TX
75354
ACTION INDUSTRIES HEALTH CARE PLAN
ADJUSTCO, INC.
ADMAR CORPORATION
ADMIN ONE
ADMINISTRATIVE BENEFITS CONSULTANTS INC
3074-00
2455-00
2847-00
3126-00
1727-00
PONTOTOC
MILWAUKEE
SANTA ANA
ROGERS
ATLANTA
MS
WI
CA
AR
GA
38863
53202
92702
72757
30341
ADMINISTRATIVE
ADMINISTRATIVE
ADMINISTRATIVE
ADMINISTRATIVE
ADMINISTRATIVE
1843-00
0030-14
3014-00
2309-00
2395-00
P O BOX 31000
MANSFIELD RD
1333 S CLEARVIEW PKWY
P O BOX 979
555 COOLIDGE ST
P O BOX 6827
12600 FAIRLAKES CIRCLE
P O BOX 619070
P O BOX 13999
P O BOX 740819
P O BOX 740819
P O BOX 189
1249 EVANGELINE THRUWAY
P O BOX 463
10159 WAYZETOR BLVD
7878 NORTH 16TH ST
SUITE 105
51 LOUISIANA AVENUE, N.W.
ONE VALLEY FORGE PLAZA
3577 KOGER BLVD/STE 400
P O BOX 51102
400 LOCUST ST
1400 ROYAL AVE
P O BOX 4705
1720 KALISTE SALOOM
4808 NORTH 22ND STREET
2570 TECHNICAL DR
#1 E WACKER DRIVE
501 S SLAGLER OR STE 600
5451 W LAKEVIEW PKWY S.
P O BOX 3262
P O BOX 13307
P O BOX 6012
5656 S STAPLES
SUITE 330
MEDICAL CONTROL
P O BOX 549005
P O BOX A
330 EAST KILBOURN/STE 380
P O BOX 478
P O BOX 2619
P O BOX 80809
12 PERIMETER PK SUITE 115
6099 MOUNT MORIAH RD #19
P O BOX 1749
P O BOX 1749
7122 N 27TH AVE #200
3800 N WILKE RD
SUITE 250
3371 E ROYALTON RD
P O BOX 839000
MEMPHIS
ROCKWALL
ROCKWALL
PHOENIX
ARLINGTON HTS
TN
TX
TX
AZ
IL
38115
75087
75087
85051
60004
BROADVIEW HEIGHTS
MIAMI
OH
FL
44147
33283
BENEFITS SERVICES
CONCEPTS INC
CONCEPTS,INC
ENTERPRISES INC
MANAGEMENT GROUP
ADMINISTRATIVE SERVICE CONSULTANTS
ADMINISTRATIVE SERVICES INC
2448-00
2881-00
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
2
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
ADMINISTRATIVE SOLUTIONS INC
ADMINISTRATIVE SYSTEMS RESEARCH CORP
ADMINISTRATORS & CONSULTANTS LTD
ADMINITRON INC
ADMIRAL LIFE INSURANCE CO. OF AMERICA
ADRIEN'S SUPERMARKET INC (SELF-INSURED)
ADVANCE PARADIGM
ADVANCED BENEFITS SOLUTIONS
ADVANCED INSURANCE SERVICES INC
ADVANCED PRESCRIPTION MANAGEMENT
ADVANTAGE DENTAL
2894-00
2188-00
2640-00
3120-00
0006-00
1972-00
2716-00
3077-00
1323-00
2330-00
1837-00
NORCROSS
GRAND RAPIDS
LANCASTER
BRENTWOOD
MINNEAPOLIS
LAFAYETTE
RICHARDSON
PHOENIX
MEMPHIS
DALLAS
DALLAS
GA
MI
PA
TN
MN
LA
TX
AZ
TN
TX
TX
30091
49516
17604
37024
55402
70508
75035
85066
38101
75381
75367
ADVANTAGE HEALTH
2841-00
NEW ORLEANS
LA
70130
ADVANTICA BENEFITS
ADVANTICAL EYECARE
3843-00
3625-00
EL PASO
ELLICOTT CITY
TX
MD
79998
21042
ADVANTRA
ADVANTRA FREEDOM
AEGON INSURANCE GROUP
AEORDIA BENEFITS OF THE SOUTH INC
H714-90
H084-60
2084-00
2382-00
LONDON
LONDON
LITTLE ROCK
DELLUTH
KY
KY
AR
GA
40742
40742
72203
30136
AEROPRES CORPORATION
AETNA
AETNA
AETNA
AETNA
AETNA
AETNA
AETNA
AETNA
AETNA
AETNA
AETNA
AETNA
AETNA
AETNA
AETNA BETTER HEALTH OF LOUISIANA
2484-00
2649-00
3399-00
3491-00
2294-00
2473-00
1170-00
1050-00
4106-00
3875-00
3852-00
3641-00
3571-00
0528-00
0726-00
9999-95
SHREVEPORT
METAIRIE
LEXINGTON
EL PASO
SAN ANTONIO
ARLINGTON
ARLINGTON
LEXINGTON
FRANKLIN
LEXINGTON
PENSACOLA
BISMARK
COLUMBIA
TYLER
MIDDLETOWN
KENNER
LA
LA
KY
TX
TX
TX
TX
KY
TN
KY
FL
ND
SC
TX
CT
LA
71137
70002
40512
79998
78279
76015
76015
40512
37067
40512
32591
58502
29224
75710
06457
70062
AETNA
AETNA
AETNA
AETNA
AETNA
AETNA
AETNA
AETNA
AETNA
AETNA
AETNA
AETNA
3757-00
3493-00
0714-00
H573-60
INT9-95
1338-00
0759-00
0828-00
1045-00
0007-00
0828-01
1199-00
P O BOX 2547
P O BOX 6392
P O BOX 4925
P O BOX 5095
910 PLYMOUTH BUILDING
107 D KALISTE SALOOM RD
P O BOX 853901
P O BOX 30570
P O BOX 1842
P O BOX 819056
PAT HANEYSSON AGENCY
P O BOX 67062
839 ST CHARLES AVE
STE 100
P O BOX 981607
3290 PINE ORCHARD LANE
STE D
P O BOX 7705
P O BOX 7154
P O BOX 8063
3575 KROGER BLVD
SUITE 450
P O BOX 70100
3900 N CAUSEWAY BLVD
P O BOX 14100
P O BOX 981106
P O BOX 795080
P O BOX 91555
P O BOX 91511
P O BOX 14079
800 CRESCENT CENTRE DRIVE
P O BOX 14588
P O BOX 13441
P O BOX 916
P O BOX 23759
P O BOX 2520
1000 MIDDLE STREET
2400 VETERANS MEM BLVD
STE 200
P O BOX 14094
P O BOX 981543
P O BOX 30167
P O BOX 981107
3838 N CAUSEWAY/33RD FLR
1000 MIDDLE STREET
1000 MIDDLE STREET
151 FORMINGTON AVE
P O BOX 14586
1000 MIDDLE STREET
P O BOX 937
P O BOX 12340
LEXINGTON
EL PASO
TAMPA
EL PASO
METAIRIE
MIDDLETOWN
MIDDLETOWN
HARTFORD
LEXINGTON
MIDDLETOWN
TOLEDO
FRESNO
KY
TX
FL
TX
LA
CT
CT
CT
KY
CT
OH
CA
40512
79998
33630
79998
70002
06457
06457
06156
40512
06457
43695
93765
DENTAL
GLOBAL BENEFITS
GOVERNMENT WIDE INDEMNITY BENEFIT PLAN
HEALTH MANAGEMENT
INTEREST PAYMENTS
LIFE & CAS
LIFE AND A
LIFE AND CASUALTY
LIFE INS CO
LIFE INSUR
LIFE INSURANCE CO
LIFE INSURANCE CO
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
3
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
AETNA
AETNA
AETNA
AETNA
AETNA
3386-00
3413-00
3020-00
0725-00
3772-00
P O BOX 398106
P O BOX 398106
P O BOX 1125
P O BOX 981109
2425 W LOOP SOUTH
SUITE 1000
P O BOX 51005
P O BOX 4661
P O BOX 10787
P O BOX 342677
1325 MASSACHUSETTS AVE
1932 WYNNTON ROAD
17775 AIRLINE HWY
4150 S. SHERWOOD FOREST
30000 AURORA RD
P O BOX 17237
444 CASTRO ST
4331 N BALLARD RD
P.O. BOX 667
P O BOX 1581
4645 SWEETWATER BLVD
SUITE 900
P O BOX 1842
525 EAST MARKET STREET
P O BOX 830623
P O BOX 36609
2600 DENALI ST
SUITE 200
P O BOX 34203
P O BOX GG
33045 HAMILTON BOULEVARD
P O BOX 7558
P O BOX 1830
P O BOX 3000
P O BOX 1436
7887 E BELLEVIEW AVENUE
O'HARE PLAZA
8501 W HIGGINS RD.
841 DOUGLAS AVE.
P O BOX 3018
P O BOX 1239
P O BOX 5147
4020 MCEWGN SUITE 285
P O BOX 89454
SRC P O BOX 23759
911 BROADWAY
P O BOX 419233
POST OFFICE BOX 1527
P O BOX 909786
P O BOX 29200
P O BOX 29186
MINNEAPOLIS
MINNEAPOLIS
BLUE BELL
EL PASO
HOUSTON
MN
MN
PA
TX
TX
55439
55439
19422
79998
77027
SHREVEPORT
HOUSTON
BURBANK
AUSTIN
WASHINGTON
COLUMBUS
BATON ROUGE
BATON ROUGE
SOLON
MEMPHIS
MOUNTAIN VIEW
APPLETON
WILMINGTON
NEPTUNE
SUGARLAND
LA
TX
CA
TX
DC
GA
LA
LA
OH
TN
CA
WI
DE
NJ
TX
71135
77210
91510
78734
20005
31999
70769
70816
44139
38187
94041
54919
19899
07754
77479
MEMPHIS
AKRON
BIRMINGHAM
BIRMINGHAM
ANCHORAGE
TN
OH
AL
AL
AK
38101
44309
35283
35236
99503
SEATTLE
BOISE
FARMINGTON HILLS
ALEXANDRIA
ALEXANDRIA
NORTHVILLE
NEW YORK
ENGLEWOOD
CHICAGO
WA
ID
MI
LA
LA
MI
NY
CO
IL
98124
83707
48018
71306
71309
48167
10116
80111
60631
LONGWOOD
MISSOULA
FORT VALLEY
SPRINGFIELD
DALLAS
CLEVELAND
COLUMBIA
KANSAS CITY
KANSAS CITY
DALLAS
CHICAGO
ST LOUIS
SHAWNEE MISSION
FL
MT
GA
IL
TX
OH
SC
MO
MO
TX
IL
MO
KS
32750
59806
31030
62705
75244
44101
29224
64105
64141
75221
60690
63126
66201
PHARM MANAGMNT
PHARMACY MANAGEMENT
U. S. HEALTHCARE
US HEALTHCARE
US HEALTHCARE
AFCO INDUSTRIES INC
AFFILIATED HEALTHCARE INC
AFFORDABLE BENEFITS ADMINISTRATORS
AFFORDABLE HEALTH CARE
AFGE HEALTH BENEFIT PLAN
AFLAC
AFU INSURANCE FUND
AGENCY MANAGEMENT CORPORATION
AGENCY RENT A CAR HOSPITALIZATION
AGENCY SERVICES INC
AGILE HEALTH INSURANCE
AID ASSOCIATION FOR LUTHERANS
AIG LIFE INSURANCE COMPANY
AIG-DENTAL BENEFIT PROVIDERS
AIM ADMINISTRATORS
1987-00
2561-00
3377-00
3274-00
0838-00
4019-00
2469-00
1667-00
2471-00
3142-00
4125-00
1495-00
0002-00
3398-00
3174-00
AIS
AKRON CITY HOSPITAL (SELF-INSURED)
ALA HEALTH NETWORK
ALABAMA DENTAL ASSOC.HEALTH TRUST INS
ALASKA ELECTRICAL TR FUND
2436-00
1451-00
2200-00
0976-00
3847-00
ALASKA PIPE TRADES WELFARE & PENSION SERVICE
ALBERTSON'S EMPLOYEE HEALTH AND WELFARE
ALEXANDER HAMILTON LIFE INS. CO. OF AMERICA
ALEXANDRIA NEWSPAPER INCORPORATED
ALEXANDRIA SEED CO (SELF-INSURED)
ALEXSIS
ALICARE INC
ALL AMERICAN ASSURANCE COMPANY
ALL AMERICAN LIFE INS. CO.
3136-00
1293-00
0008-00
1466-00
2374-00
1881-00
3139-00
0009-00
0010-00
ALL RISK CORPORATION OF LOUISIANA
ALLEGIANCE BENEFIT PLAN MANAGEMENT
ALLEN MEDICAL CLAIMS ADMINISTRATOR INC
ALLIANCE LIFE INSURANCE COMPANY
ALLIANCE PRESCRIPTION CHOICE
ALLIANT HEALTH PLANS
ALLIANZ
ALLIED ADMINISTRATORS
ALLIED ASSOCIATION
ALLIED BANKERS LIFE INSURANCE COMPANY
ALLIED BENEFITS SYSTEMS INC
ALLIED EMPLOYER'S ASSOCIATION
ALLIED NATIONAL
0523-00
3407-00
2642-00
0011-00
1602-00
3289-00
2863-00
1272-00
2404-00
0012-00
3033-00
1226-00
4107-00
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
4
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
ALLMERICA INSURANCE
ALLSTATE
ALLSTATE LIFE INSURANCE CO
2635-00
3594-00
0013-01
WORCHESTER
JACKSONVILLE
N SUBURBAN
MA
FL
IL
01605
32224
60199
ALLSTATE LIFE INSURANCE COMPANY
ALLSTATE WORKPLACE DIVISION
ALPHA CORPORATION
0013-00
3457-00
1303-00
NORTHBROOK
RICHARDSON
BATON ROUGE
IL
TX
LA
60062
75085
70898
ALTA HEALTH
ALTA RX
ALTERNATIVE
ALTERNATIVE
ALTERNATIVE
ALTERNATIVE
0907-00
2150-00
1705-00
4038-00
2976-00
2651-00
440 LINCOLN ST
1776 AMERICAN HERITAGE
CLAIMS FILING
P O BOX 9016
ALLSTATE PLAZA
P O BOX 853916
8322 ONE CALAIS AVE
P O BOX 14786
P O BOX 671088
P O BOX 54190
P O BOX 26841
P O BOX 921849
P O BOX 660787
3275 N ARLINGTON HTS RD
SUITE 401
P O BOX 95950
P O BOX 80139
7380 NORTH LINCOLN AVENUE
770 BROADWAY
120 N MADISON ST
5353 ESSEN LANE
SUITE 450
P O BOX 35750
#1 HESS PLAZA
2721 N CENTRAL AVE
P O BOX 853914
14180 DALLAS PARKWAY
SUITE 504
P O BOX 7186
P O BOX 5347
P O BOX 16708
P O BOX 398220
P O BOX 93670
4334 NW EXPRESSWAY
STE 207
P O BOX 53070
1903 W CHURCH ST
POST OFFICE BOX 7430
P O BOX 6456
12600 NORTHBOROUGH DR
SUITE 300
3200 EAST CARSON STREET
P O BOX 1579
POST OFFICE BOX 1700
11222 QUAIL ROOST DRIVE
P O BOX 469
POST OFFICE BOX 2228
2626 S SHERIDAN
STE 200
POST OFFICE BOX 42814
1707 ORLANDO CENT.PARKWAY
HOUSTON
LOS ANGELES
OKLAHOMA CITY
NORCROSS
BIRMINGHAM
ARLINGTON HEIGHTS
TX
CA
OK
GA
AL
IL
77267
90054
73126
30010
35266
60004
SOUTH JORDAN
BATON ROUGE
LINCOLNWOOD
NEW YORK
THOMASVILLE
BATON ROUGE
UT
LA
IL
NY
GA
LA
84095
70898
60646
10003
31792
70809
TULSA
WOODBRIDGE
PHOENIX
RICHARDON
DALLAS
OK
NJ
AZ
TX
TX
74153
07095
85004
75085
75240
BOISE
BOISE
JACKSON
MINNEAPOLIS
LUBBOCK
OKLAHOMA CITY
ID
ID
MS
MN
TX
OK
83707
83705
39236
55439
79493
73116
LUBBOCK
HAMMOND
ATLANTA
METAIRIE
HOUSTON
TX
LA
GA
LA
TX
79453
70401
30357
74009
77067
LAKEWOOD
OPELOUSAS
WACO
MIAMI
BILOXI
DECATUR
TULSA
CA
LA
TX
FL
MS
AL
OK
90712
70571
76703
33157
39533
35602
74129
HOUSTON
ORLANDO
TX
FL
77242
32809
STRATEGIES
BENEFIT CONSULTANTS
BENEFIT PLANS, INC.
INSURANCE RESOURCES INC
RISK MANAGEMENT LTD
ALTIUS HEALTH PLANS
ALWAYSCARE BENEFITS INC
AMALGAMATED LABOR LIFE INS. CO
AMALGAMATED LIFE INSURANCE COMPANY
AMBASSDOR
AMCARE HEALTH PLAN OF LOUISIANA
4090-00
3428-00
0014-00
1449-00
3661-00
3023-00
AMCARE HEALTH PLAN OF OKLAHOMA
AMERADA HESS CORPORATION
AMERCO INSURANCE
AMERI HEALTH MERCY OF LOUISIANA
AMERI PLAN USA
2990-00
2276-00
3167-00
4027-00
2791-00
AMERIBEN
AMERIBEN SOLUTIONS
AMERICA FIRST INSURANCE CO
AMERICA TPA
AMERICAN ADMINISTRATIVE GROUP
AMERICAN ADMINISTRATIVE INC
3662-00
3083-00
3161-00
3958-00
3495-00
2992-00
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
ADMINISTRATORS GROUP
ADVANTAGE INSURANCE
AGENCY LIFE INS. CO.
AMBULANCE AND MEDICAL RESCUE SERVICE
ASSOCIATION OF PETROLEUM LANDMEN
3316-00
1157-00
0015-00
0809-00
1069-00
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
ASSOCIATION OF RETIRED PERSONS
BANK & TRUST CO. (SELF-INSURED)
BANKERS INSURANCE COMPANY
BANKERS LIFE ASSUR. CO. OF FL
BENEFIT ADMINISTRATORS INC
BENEFIT LIFE INS. CO.
BENEFITS CO INC
1373-00
2419-00
0017-00
0018-00
1890-00
0019-00
3211-00
AMERICAN CAPITOL INS. CO.
AMERICAN CASUALTY CO
0020-00
0986-00
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
5
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
AMERICAN CHAMBERS LIFE INS. CO.
0021-00
WORTHINGTON
OH
43085
AMERICAN COMBINED LIFE INSURANCE COMPANY
AMERICAN COMMERCIAL BARGE-LINE
AMERICAN COMMERCIAL TRUST AND HEALTH
2490-00
1353-00
0923-00
LANGHORNE
JEFFERSONVILLE
LOWELL
PA
IN
MA
19047
47130
01852
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
COMMUNITY MUTUAL INS. CO.
CONSULTING ENGINEERS COUNC
CONSUMERS LIFE INS. CO.
CONTINENTAL INSURANCE
CONTINENTAL INSURANCE
0022-00
3153-00
0023-00
3981-00
4057-00
LIVONIA
ST LOUIS
ATLANTA
BRENTWOOD
FRANKLIN
MI
MO
GA
TN
TN
48152
63101
30329
37024
37067
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
COTTON GROWERS, PCCA TEXTILE DIVISION
CYANAMID CO.
DEFENDER LIFE INS. CO.
DENTAL PLAN INC
EDUCATORS LIFE INSURANCE
EMPLOYERS BENEFIT TRUST MEDICAL PLAN
EQUITABLE LIFE INS. CO.
EXCESS UNDERWRITERS INC
2574-00
1150-00
0024-00
2391-00
2316-00
2205-00
0025-00
0892-00
LITTLEFIELD
WAYNE
RALEIGH
GAINESVILLE
BIRMINGHAM
HOUSTON
DALLAS
METAIRIE
TX
NJ
NC
FL
AL
TX
TX
LA
79339
07474
27602
32602
35216
77252
75231
70001
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
EXCHANGE LIFE INSURANCE COMPANY
FABRICS CO.
FAMILY INSURANCE
FAMILY LIFE ASSUR. CO. OF COLUMBUS
FAVORITE CHICKEN CO.(SELF-INSURED)
FEDERATIONS OF UNIONS-LOCAL 102
FIDELITY ASSURANCE CO.
FOUNDERS LIFE INS. CO.
FREIGHTWAYS (SELF-INSURED)
GENERAL (DENTAL)
GENERAL GROUP INSURANCE COMPANY
GENERAL GROUP SERVICE
GENERAL LIFE INS CO
GENERAL LIFE INS CO
GENERAL LIFE INS. CO.
GENERAL LIFE INS. CO. OF DE
GENERAL LIFE INS-CO
GENERAL NATIONAL LIFE & ACCIDENT INS.CO.
GROUP ADMINISTRATORS INSURANCE
GUARANTY LIFE INS. CO.
HEALTH AND ACCIDENT LIFE INS CO
HEALTH AND LIFE INS. CO.
HEALTH CARE DENTAL INSURANCE SYSTEMS INC
HEALTH NETWORK
1328-00
1807-00
1584-00
0026-00
2695-00
0529-00
0027-00
0028-00
2428-00
3824-00
0839-00
1381-00
3877-00
3771-00
0029-00
0030-00
0029-01
1894-00
1556-00
0031-00
0724-00
0032-00
2099-00
2157-00
DALLAS
BRIDGEPORT
MADISON
COLUMBUS
ATLANTA
PRAIRIEVILLE
OKLAHOMA CITY
AUSTIN
HARRISON
LAS VEGAS
DALLAS
JACKSONVILLE
BRENTWOOD
CLEARWATER
HOUSTON
HOUSTON
NASHVILLE
BOSTON
HENDERSONVILLE
PORTLAND
ENNIS
BALTIMORE
NEW ORLEANS
NASHVILLE
TX
CT
WI
GA
GA
LA
OK
TX
AR
NV
TX
FL
TN
FL
TX
TX
TN
MA
TN
OR
TX
MD
LA
TN
75221
06607
53704
31999
30302
70769
73125
78761
72602
89116
75266
32303
37024
33757
77001
77001
37250
02112
37077
97201
75119
21202
70179
37203
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
HEALTH TRUST
HERITAGE LIFE
INCOME LIFE INS. CO.
INSTITUTE OF ARCHITECTS - BENEFIT TRUST INS
INSTITUTE OF MANAGEMENT SERVICES
1107-00
0033-00
0034-00
1459-00
0900-00
406 E WILSON BRIDGE RD
STE.C
P O BOX 1009
P O BOX 610
PHA INC
18 POIMER STREET
39201 SEVEN MILE ROAD
P O BOX 9007
POST OFFICE BOX 49527
P O BOX 5008
800 CRESCENT CENTER DRIVE
SUITE 200
P O BOX 512
P O BOX 509
20 EAST MARTIN STREET
P O BOX 5309
P O BOX 20787
P O BOX 2465
10300 N CENTRAL EXP
4621 W NAPOLEON AVE
SUITE 300
P O BOX 1530
1069 CONNECTICUT AVE
3099 EAST WASHINGTON AVE
1932 WYNNTON RD
6 CONCORD PKWY
P O BOX 1002
POST OFFICE BOX 25523
6937 N INTERREGIONAL HWY
P O BOX 840
P O BOX 43119
PO BOX 660238
P O BOX 2568
P O BOX 1188
P O BOX 10845
POST OFFICE BOX 1931
POST OFFICE BOX 3247
AMER GEN CEN -NASHVILLE
P O BOX 105 ESSEX STATI
P O BOX 1349
1433 S. W. 6TH AVENUE
P O BOX 490
300 ST. PAUL PLACE
P O BOX 791120
3322 WEST END AVE
SUITE 775
P O BOX 899
1776 AMERICAN HERITAGE DR
POST OFFICE BOX 208
400 LOCUST
PO BOX 11107
CLEARWATER
JACKSONVILLE
WACO
DES MOINES
WINSTON-SALEM
FL
FL
TX
IA
NC
33517
32224
76703
50398
27116
LAM1R032
RUN: 09/24/16 07:28:56
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DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
6
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
0035-00
1684-00
2885-00
0713-00
1067-00
110 W 7TH ST
P O BOX 6011
P O BOX 16725
2 PENN CENTER PLAZA
SUITE 1752
601 POYDRAS ST
102 MAIDEN LANE
POST OFFICE BOX 2039
4962 FLORIDA BLVD.
SUITE 302
P O BOX 1600
207 FIFTH STREET NORTH
P O BOX 3680
7 CLAYTON STREET
1932 WYNNTON RD
1100 POYDRAS ST
SUITE 2600
208 SOUTH LASALLE STREET
810 SEVENTH AVENUE
P O BOX 14786
P O BOX 1449
P O BOX 1449
P O BOX 35
P O BOX 35
200 N LASALLE
STE 400
BENEFIT TRUST
AMI P O BOX 2178
P O BOX 1353
P O BOX 19032
P O BOX 6960
ONE MOODY PLAZA
17TH FLOOR
P O BOX 696520
P O BOX 7100
AMERICAN PATRIOT
HEALTH SERVICE CENTER
P O BOX 130
POST OFFICE BOX 3509
P O BOX 3279
4888 LOOP CENTRAL DR
SUITE 700
WOODWYNDS PROFESSIONAL
BUILDING, ROUTE 6
PO BOX 1068
1560 WILSON BLVD
SUITE 1000
BOX 925
BOX 21627
P O BOX 2876
4725 N SCOTTSDALE RD
SUITE 351
FORT WORTH
SHERMAN OAKS
JACKSON
PHILADELPHIA
NEW ORLEANS
TX
CA
MS
PA
LA
76102
91413
39236
19102
70130
NEW YORK
TOPEKA
BATON ROUGE
NY
KS
LA
10270
66601
70821
DALLAS
FARGO
LAGUNA
MONTGOMERY
COLUMBUS
NEW ORLEANS
TX
ND
CA
AL
GA
LA
75221
58102
92654
36104
31999
70163
CHICAGO
NEW YORK
BATON ROUGE
GODDLETTSVILLE
GOODLETTSVILLE
DANIA
DANIA
CHICAGO
IL
NY
LA
TN
TN
FL
FL
IL
60604
10019
70898
37070
37370
33004
33004
60601
COSTA MESA
CA
92628
CHICAGO
GREEN BAY
METAIRIE
GALVESTON
IL
WI
LA
TX
60690
54307
70006
77550
SAN ANTONIO
SHREVEPORT
TREVOSE
TX
LA
PA
78269
71134
19094
PENSACOLA
ORLANDO
SILVER SPRING
HOUSTON
FL
FL
MD
TX
32591
32802
20918
77081
BREWSTER
NY
10505
HATTIESBURG
ARLINGTON
MS
VA
39401
22209
JACKSON
COLUMBIA
MILWAUKEE
SCOTTSDALE
MS
SC
WI
AZ
39205
29221
53201
85251
INSURANCE COMPANY OF TX
INSURANCE CONSULTANTS INC
INSURANCE GROUP P.A.
INTEGRITY INSURANCE COMPANY
INTERNATIONAL ADJUSTMENTS INS CO
AMERICAN INTERNATIONAL LIFE ASSUR. CO. OF NY
AMERICAN INVERSTORS LIFE INS. CO., INC.
AMERICAN LIBERTY LIFE INS. CO.
0036-00
0037-00
0038-00
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
LIFE
LIFE
LIFE
LIFE
LIFE
LIFE
0957-00
0040-00
2162-00
0039-00
1557-00
2628-00
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
LIFE INSURANCE COMPANY
LIFE INSURANCE COMPANY OF NEW YORK
LIFE PENSION HEALTH ASSOC
LIFECARE
LIFECARE
MARITIME OFFICERS MEDICAL PLAN
MARITIME OFFICERS MEDICAL PLAN
MEDICAL ASSOC INSURANCE
AND ACCIDENT INSURANCE COMPANY
AND CASUALTY INS. CO.
AND HEALTH
ASSURANCE CORP., THE
ASSURANCE OF COLUMBUS
CARE
1510-00
1583-00
1413-00
3487-00
3486-00
2796-00
2787-00
2864-00
AMERICAN MEDICAL INTERNATIONAL EMPLOYEE
1266-00
AMERICAN
AMERICAN
AMERICAN
AMERICAN
3767-00
1946-00
1575-00
0041-00
MEDICAL LIFE
MEDICAL SECURITY
NATIONAL AGENCY
NATIONAL INS. CO.
AMERICAN NATIONAL LIFE INS CO
AMERICAN OIL FIELD DIVER'S INC
AMERICAN PATRIOT HEALTH INS. CO.
3820-00
2369-00
0042-00
AMERICAN
AMERICAN
AMERICAN
AMERICAN
3695-00
0043-00
0706-00
H277-50
PIONEER
PIONEER LIFE INS. CO.
POSTAL WORKERS UNION
PROGRESSIVE
AMERICAN PROGRESSIVE LIFE & HEALTH INS. CO. OF NY
0044-00
AMERICAN PROTECTIVE LIFE INSURANCE COMPANY
AMERICAN PSYCHMANAGEMENT INC
0942-00
2389-00
AMERICAN
AMERICAN
AMERICAN
AMERICAN
0045-00
1019-00
1719-00
2300-00
PUBLIC LIFE INS. CO.
PULPWOOD ASSOCIATION
PUMP CO., INC
RADIO ASSOCIATION WELFARE PLAN
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
7
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
REBUBLIC INS. CO.
RESERVE LIFE INS. CO.
RETIREMENT LIFE INS CO
SECURITY LIFE INS. CO.
SEED TRADE ASSOCIATION BENEFITS
SELFCARE CORPORATION
0046-00
1518-00
3992-00
0047-00
1870-00
2349-00
DES MOINES
TULSA
AUSTIN
SAN ANTONIO
DELHI
GLEN ELLYN
IA
OK
TX
TX
LA
IL
50301
74119
78755
78206
71232
60137
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
SENTINEL
SENTINEL INS CO
SERVICES
SPECIALTY
STANDARD LIFE AND ACCIDENT INS. CO.
STATE INSURANCE
STATE INSURANCE CO
STERLING INSURANCE CO
TEACHERS LIFE INS CO
TRANSPORTATION SERVICE INCORPORATED
TRAVELERS LIFE INSURANCE COMPANY
TRUST ADMINISTRATORS INC
UNDERWRITERS LIFE INSURANCE COMPANY
UNION LIFE INS. CO.
UNITED LIFE INS. CO.
VETERINARY MEDICAL ASSOCIATION GROUP
3475-00
3540-00
0776-00
3449-00
0048-00
1038-00
1563-00
3325-00
1004-00
2219-00
1274-00
1415-00
2043-00
0049-00
0050-00
1826-00
POST OFFICE BOS 10
1722 SOUTH CARSON
P O BOX 300100
POST OFFICE BOX 2341
P O BOX 428
800 ROOSEVELT ROAD
BLDG E,STE 200
P O BOX 61140
P O BOX 61140
300 BAILEY
P O BOX 459
POST OFFICE BOX 1746
PO BOX 15885
P O BOX 1636
P O BOX 26103
P O BOX 1628
P O BOX 1791
1800 STREET ROAD
P O BOX 87
P O BOX 29683
5217 ROSS AVENUE
POST OFFICE BOX 190-B
HEALTH & LIFE INS
55E JACKSON BLVD 8TH FL.
425 AUSTIN AVENUE
P O BOX 922043
P O BOX 5220
P O BOX 33757
505 S LENOLA RD
SUITE 231
3850 N CAUSEWAY BLVD
STE 1160
3850 N CAUSEWAY BLVD
STE 1160
22 CENTURY BLVD
5112 ARTS ST
P O BOX 21545
720 BLAIR MIL ROAD
22500 METROPOLITAN PKWY
STE 100
P O BOX 82520
P O BOX 61010
P O BOX 3000
1650 LOS GAMOS DR
650 POYDRAS ST SUITE 1900
P O BOX 2178-E
P O BOX 200579
306 S. 15TH STREET
P O BOX 2187
P O BOX 34680 MEDICAL
P O BOX 34680 DENTAL
HARRISONBURG
HARRISBURG
FORT WORTH
ROANOKE
ENID
WEST PALM BEACH
INDIANAPOLIS
OVERLAND PARK
HUMBLE
WILMINGTON
WARRINGTON
SHAWNEE MISSION
DALLAS
DALLAS
INDIANAPOLIS
CHICAGO
PA
PA
TX
IN
OK
FL
IN
KS
TX
DE
PA
KS
TX
TX
IN
IL
17106
17106
76107
46783
73701
33406
46206
66225
77347
19899
18976
66201
75229
75206
46206
60604
WACO
HOUSTON
KINGSTON
INDIANAPOLIS
MOORESTOWN
TX
TX
NY
IN
NJ
76703
77292
12402
46203
08057
METAIRIE
LA
70002
METAIRIE
LA
70002
NASHVILLE
NEW ORLEANS
EAGEN
HORSHAM
CLINTON TOWNSHIP
TN
LA
MN
PA
MI
37214
70122
55121
19044
48035
LINCOLN
VIRGINIA BEACH
MONTEREY PK
SAN RAFAEL
NEW ORLEANS
COSTA MESA
AUSTIN
OMAHA
CLIFTON
LOUISVILLE
NE
VA
LA
CA
LA
CA
TX
NE
NJ
KY
68501
23466
91754
94903
70130
92628
78720
68102
07015
40232
AMERICAN-AMICABLE LIFE INS. CO.
AMERICAS CHOICE HEALTHPLANS
AMERICHOICE SECURE PLUS
AMERICORPS
AMERICORPS BENEFITS
0016-00
3244-00
H338-70
3189-00
3804-00
AMERIGROUP OF LOUISIANA
9999-92
AMERIGROUP OF LOUISIANA INTEREST PAYMENTS
INT9-92
AMERIGROUP TENNESSEE INC
AMERIHEALTH
AMERIHEALTH ADMINISTRATORS
AMERIHEALTH ADMINISTRATORS
AMERIPLAN INC
3836-00
4046-00
3964-00
3193-00
3206-00
AMERITAS LIFE INSURANCE CORP
AMERIVANTAGE MEDICARE PLAN
AMERRON MEDICAL DENTAL PLAN
AMEX LIFE ASSURANCE COMPANY
AMI CHOICE PLUS
AMI SOUTH COAST CLAIMS
AMIL INTERNATIONAL
AMOCO LIFE INS. CO.
AMPCO PITTSBORGH CORP NATL PRESCRIPTION ADM.
AMRE INC HEALTH BENEFITS PROGRAM
2110-00
H589-60
1595-00
2173-00
1788-00
0991-00
3241-00
0051-00
2683-00
1773-00
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
8
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
AMS INSURANCE PLANS
AMSTAR SUGAR CORPORATION
ANCHOR BENEFITS CONSULTANT
ANDREW JACKSON LIFE INS. CO., THE
2431-00
2019-00
2910-00
0052-00
NEVERSINK
ARABI
MAITLAND
JACKSON
NY
LA
FL
MS
12765
70032
32794
39216
ANNUITIES AND RELIEF
ANNUITY BOARD OF THE SOUTHERN BAPTIST CONVENTION
ANPAC LOUISIANA INSURANCE COMPANY
0752-00
1236-00
3629-00
ATLANTA
ST. LOUIS
SPRINGFIELD
GA
MO
MO
30365
63188
65899
ANSELL-EDMONT
ANTHEM AMERICAN HEALTH NETWORK
ANTHEM AVONDALE REPRESENTED PPO
ANTHEM BLUE CROSS
ANTHEM HEALTH & LIFE INSURANCE
ANTHEM LIFE INSURANCE CO. OF IN.
ANTHEM STANDARD PPO
ANTHONY ACTIVE MEDICAL
AON SELECT INC
APA PARTNERS INC
2393-00
2513-00
3791-00
4025-00
1857-00
2050-00
3538-00
2617-00
3029-00
3076-00
HAYNESVILLE
DALLAS
LOS ANGELES
ATLANTA
PISCATAWAY
INDIANAPOLIS
CLEVELAND
OMAHA
HORSHAM
LATHAM
LA
TX
CA
GA
NJ
IN
OH
NE
PA
NY
71038
75265
90060
30302
08855
46206
44125
68103
19044
12110
APEX HEALTHCARE
APICAL HEALTH SOLUTIONS
APPALACHIAN BENEFIT ADMINISTRATORS
APPALACHINA NATIONAL LIFE INS. CO.
APS HEALTHCARE
APWU
ARCADIAN COMMUNITY CARE
ARCADIAN HEALTH PLAN
ARCHDI0CESE OF NEW ORLEANS RELIGIOUS HEALTH PLAN
ARETHUSA (SELF-INSURED)
2752-00
3203-00
3760-00
0053-00
3224-00
3745-00
3584-00
H570-00
1601-00
2483-00
BIRMINGHAM
LAS VEGAS
WAYNESVILLE
KNOXVILLE
ROCKVILLE
GLEN BURNIE
SHREVEPORT
COVINA
NEW ORLEANS
HOUSTON
AL
NV
NC
TN
MD
MD
LA
CA
LA
TX
35238
89193
28786
37901
20849
21060
71106
91723
70114
77002
ARGIS EMPLOYEE BENEFIT PLAN TRUST
ARGIS INCORPORATED
ARGUS
ARGUS
ARGUS
ARIES MARINE CORPORATION
ARK-LA-MISS LABORERS WELFARE FUND
ARKANSAS FREIGHTWAYS
1168-00
1134-00
3414-00
3388-00
3387-00
3276-00
2190-00
1534-00
LITTLE ROCK
WINNSBORO
KANSA CITY
KANSA CITY
SCRANTON
LAFAYETTE
METAIRIE
OVERLAND PARK
AR
LA
MO
MO
PA
LA
LA
KS
72203
71295
64141
64141
18505
70505
70001
66212
ARKANSAS MANAGED CARE ORGANIZATION
ARKANSAS MUNICIPAL LEAUGE
ARKANSAS RETAIL GROCERS INSURANCE SERVICES
ARKLA GAS CO
ARMOUR LIFE INS. CO.
ARMSTRONG MEDICAL CARE & DENTAL ASSISTANCE PLANS
2902-00
0815-00
1273-00
0930-00
0054-00
1963-00
LITTLE ROCK
CROSSETT
DALLAS
SHREVEPORT
KANSAS CITY
GREENVILLE
AR
AR
TX
LA
MO
SC
72221
71635
75380
71151
64141
29662
ARROW TRUCKING CO GROUP HEALTH PLAN
ARS BENEFITS INC
ASBESTOS LOCAL #53 WELFARE PLAN
ASBESTOS WORKERS LOCAL #21
2913-00
2154-00
1202-00
1993-00
P O BOX 606
7417 N PETERS
P O BOX 945260
POST OFFICE BOX 5025
FONDREN STATION
341 PONCE DE LOON AVE NE
P O BOX 1086
CORPORATE CENTRE
1949 E SUNSHINE
RT 1 BOX E-W
P O BOX 650342
P O BOX 60007
P O BOX 4445
P O BOX 6880
P O BOX 6146
8333 ROCKSIDE RD
P O BOX 3039
110 GIBRALTAR ROAD
8 BRITISH AMERICAN BLVD
P O BOX 1506
P O BOX 381173
P O BOX 95638
P O BOX 780
POST OFFICE BOX 2647
P O BOX 1246
P O BOX 1358
920 PIERREMONT RD/STE 506
P O BOX 4946
1529 NEWTON ST
600 TRAVIS
SUITE 160
P O BOX 3627
204 FAIR AVENUE
P O BOX 419019
P O BOX 419019
P O BOX 3598
P O DRAWER 51789
4200 S I-10 SERV RD, #134
C/O LA HOOD & ASSOCIATES
P O BOX 12170
P O BOX 22118
P O BOX 338
P O BOX 802516
PO BOX 21734
POST OFFICE BOX 19089
ARMSTRONG WORLD IND. INC
P O BOX 5515
P O BOX 3097
P O BOX 1553
2540 SEVERN SUITE 206
11580 REEDER RD
TULSA
SMYRNA
METAIRIE
DALLAS
OK
GA
LA
TX
74101
30081
70002
75229
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
9
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
ASCO-U. S.
ASHLAND OIL EMPLOYEE MEDICAL PLAN
ASMR CORP
3175-00
0704-00
3359-00
HOUSTON
LEXINGTON
MOORESTOWN
TX
KY
NJ
77024
40512
08057
ASPLUNDH TREE EXPERT CO
ASRM
1744-00
4053-00
WILLOW GROVE
MOOESTOWN
PA
NJ
19090
08057
ASRM CORP
3320-00
314 NORTH POST OAK LANE
P O BOX 14000
509 S LENOLA RD
BLDG 2
BLAIR MILL ROAD
505 SOUTH LENDA ROAD
SUITE 231
509 S LENOLA RD
BLDG #2
2210 NORTH MAIN
POST OFFICE BOX 10487
3855 PRESIDENTIAL PARKWAY
P O BOX 31045
P O BOX 160184
3636 S I-10 SERVICE RD
#204
2811 LORD BALTIMORE DR
1101 N 3RD ST
P O BOX 1553
PO BOX 545
3333 N MERIDIAN ST
P O BOX 2510
OFFICE OF PERSONNEL MGMT
1900 E STREET NW
P O BOX 23099
735 NORTH SECOND STREET
13601 PRESTON RD
SUITE 201E, LOCK BOX 108
HEALTH BENEFIT FUND
P O BOX 518
P O BOX 2940
P O BOX 2806
P O BOX 981602
P O BOX 91604
P O BOX 624
P O BOX 42033
P O BOX 52136
13700 WATERTOWER CIRCLE
SUITE D
P O BOX 82533
P O BOX 21627
110 RAILROAD AVENUE
P O BOX 6146
100 AUBURN AVENUE, N.E.
POST OFFICE BOX 49586
POST OFFICE BOX 10072
132 B HARBOR CIRCLE
NEW ORLEANS EAST BRANCH
P O BOX 1362
P O BOX 7077
P O BOX 362889
MOORESTOWN
NJ
08057
NORTH LITTLE ROCK
BIRMINGHAM
ATLANTA
BIRMINGHAM
MOBILE
METAIRIE
AR
AL
GA
AL
AL
LA
72114
35202
30340
35222
36616
70001
BALTIMORE
MONROE
SMYRNA
LEEDS
INDIANAPOLIS
ROCKVILLE
WASHINGTON
MD
LA
GA
AL
IN
MA
DC
21207
71201
30081
35094
46208
20852
20415
SHAWANEE MISSION
MILWAUKEE
DALLAS
KS
WI
TX
70886
53203
75240
NAPOLEONVILLE
LA
70390
CLINTON
CLINTON
EL PASO
LUBBOCK
MILWAUKEE
HAZELWOOD
PHOENIX
PLYMOUTH
IA
IA
TX
TX
WI
MO
AZ
MN
52733
52733
79998
79490
53201
63042
85072
55441
LINCOLN
COLUMBIA
DONALDSONVILLE
INDIANAPOLIS
ATLANTA
ATLANTA
ATLANTA
NEW ORLEANS
NE
SC
LA
IN
GA
GA
GA
LA
68501
29221
70346
46206
30303
30329
30319
70126
PISCATAWAY
PASADENA
SAN JUAN
NJ
CA
PR
08855
91109
00930
ASSOCIATED
ASSOCIATED
ASSOCIATED
ASSOCIATED
ASSOCIATED
ASSOCIATED
BUILDERS & CONTRACTORS OF ARKANSAS
DOCTORS HEALTH AND LIFE INS. CO.
GENERAL CONTRACTORS OF AMERICA
GROUP SERVICE INC
HEALTH ADMINISTRATORS
HEALTH PLANS OF LA.
0903-00
0055-00
1892-00
0730-00
1590-00
0816-00
ASSOCIATED PRESCRIPTION SERVICES
ASSOCIATED RESOURCES MANAGEMENT INC
ASSOCIATED RISK SERVICES
ASSOCIATED TIRE DEALERS ASSOCIATION
ASSOCIATES LIFE INS. CO.
ASSOCIATION & SOCIETY INSURANCE CORPORATION
ASSOCIATION BENEFIT PLAN
1316-00
3006-00
2198-00
0842-00
0056-00
2394-00
3265-00
ASSOCIATION INSURANCE SERVICES INC
ASSOCIATION LIFE INS. CO., INC.
ASSOCIATIONS COMBINED TRUST
2270-00
0057-00
1035-00
ASSUMPTION PARISH POLICE JURY EMPLOYEE
2014-00
ASSURANT EMPLOYEE BENEFITS
ASSURANT HEALTH
ASSURANT HEALTH
ASSURANT HEALTH
ASSURANT HEALTH
ASSURANT HEALTH
ASSURANT HEALTH ACCESS
ASSURE CARE
3450-00
3758-00
3473-00
4023-00
3816-00
3317-00
4001-00
3056-00
ASSURITY LIFE INSURANCE
ATA DAVIS GARVIN AGENCY
ATALS LIFE INSURANCE COMPANY
ATHENS LIFE INSURANCE
ATLANTA LIFE INS. CO.
ATLANTIC & PACIFIC LIFE INS. CO. OF AMERICA
ATLANTIC AMERICAN LIFE INS. CO.
ATLANTIC ENVELOPE COMPANY
3302-00
0797-00
0718-00
2581-00
0058-00
0060-00
0059-00
2715-00
ATLANTIC HOME TRUST
ATLANTIC RICHARD CORP.(SELF INSURED)
ATLANTIC SOUTHERN INS CO
2130-00
1122-00
2355-00
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
10
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
ATLANTICARE HEALTH PLANS
ATLAS ADMINISTRATORS
ATTA ADMINISTRATORS
AUDUBON LIFE INS. CO.
AUGUST INTERNATIONAL
3250-00
2940-00
1184-00
0061-00
1754-00
MAMMONTON
DALLAS
BOISE
BATON ROUGE
DALLAS
NJ
TX
ID
LA
TX
08037
75380
83705
70821
75206
AULTCARE
AULTRA ADMINISTRATIVE GROUP
AUSTIN & MERRITT
AUSTIN INDUSTRIES-HUMAN RESOURCES DEPT
AUTO MACHINIST HEALTH & WELFARE FUND
AUTO ZONE BENEFITS
3479-00
3443-00
1280-00
1147-00
2210-00
1594-00
CANTON
CANTON
PORT CHESTER
DALLAS
SEATTLE
MEMPHIS
OH
OH
NY
TX
WA
TN
44706
44735
10573
75221
98124
38111
AUTOMOTIVE BENEFITS SERVICES
AUXIANT
1862-00
3936-00
HOUSTON
CEDAR RAPIDS
TX
IA
77242
52401
AV MED
AV MED OF LOUISIANA
3893-00
0988-00
MIAMI
METAIRIE
FL
LA
33156
70002
AVESIS
AVMA GROUP HEALTH & LIFE
AVON GROUP INS PROGRAM
AVONDALE INDUSTRIES (SELF INSURED)
AVOYELLES WHOLESALE GROCERY
AVOYELLES WHOLESALE LTD
B & C HEALTH BENEFITS
B A A I
B.E.AND K INC
3890-00
3281-00
0891-00
1716-00
1110-00
1034-00
2947-00
2377-00
2801-00
PHOENIX
CHICAGO
SPRINGFIELD
NEW ORLEANS
ALEXANDRIA
ALEXANDRIA
KENSINGTON
SIOUX CITY
SPARTANBURG
AZ
IL
MA
LA
LA
LA
MD
IA
SC
85011
60690
01101
70150
71301
71335
20895
51102
29306
B'NAI BOITH MEMBERS INSURANCE PROGRAM
BAC LOCAL #2 ALBANY
2168-00
2734-00
MCLEAN
ALBANY
VA
NY
22102
12206
BAKERY & CONFECTIONARY UNION
BALDOR INSURANCE
1345-00
2482-00
KENSINGTON
FT SMITH
MD
AR
20895
72902
BALL-INCON (SELF-INSURED)
BANCROFT BAG (SELF-FUNDED)
BANKER'S TRUST CO
BANKERS COMMERCIAL LIFE INS. CO.
BANKERS FIDELITY LIFE INS. CO.
BANKERS INSURANCE CO. FJUA
BANKERS LIFE AND CASUALTY
BANKERS LIFE AND CASUALTY
BANKERS LIFE COMPANY
BANKERS LIFE INS. CO. OF NE
BANKERS MUTIPLE LINE INS. CO.
BANKERS SECURITY LIFE INS. SOCIETY
BANKERS UNITED LIFE ASSURANCE CO.
BANNER LIFE INS. CO.
BAPTIST HEALTH SERVICES GROUP
BARNES AND NOBLE,INC
2265-00
2260-00
1823-00
0063-00
0064-00
1761-00
0065-00
3812-00
0066-00
0067-00
0068-00
0069-00
0070-00
0071-00
2871-00
2183-00
P O BOX 613
P O BOX 801234
BOX GG
POST OFFICE BOX 2547
5910 N CENTRAL EXPRESSWAY
SUITE 400
P O BOX 6910
P O BOX 35276
P O BOX 1391
P O BOX 1590
P O BOX C34203
3030 POPLAR AVENUE
DEPT 8204-2
P O BOX 42043
225 2ND ST SE
SUITE 500
9400 SOUTH DADELAND BLVD
2900 RIDGELAKE DRIVE
SUITE 440
P O BOX 7777
P O BOX 909720
P O BOX 9004
P O BOX 50280
3015 BROADWAY
BOX 5725
10401 CONNECTICUT AVE
P O BOX 9900
145 N CHURCH ST
SUITE 300
P O BOX 1030
NY HEALTH BENEFIT FUND
8 RUSSELL ROAD
10401 CONNECTICUT AVENUE
5711 S 7TH
P O BOX 2400
P O DRAWER 789
P O BOX 70100
WALL ST
5720 LBJ FREEWAY
POST OFFICE BOX 10245
P O BOX 33023
P O BOX 66927
P O BOX 1935
711 HIGH STREET
COTNER AT "O" STREET
4810 N. KENNETH AVENUE
1701 PENNSYLVANIA AVE N W
POST OFFICE BOX 1447
1701 RESEARCH BLVD.
P O BOX 249
P O BOX 833823 DEPT 198
RUSTON
SHREVEPORT
NEW YORK
DALLAS
ATLANTA
SAINT PETERSBURG
CHICAGO
CARMEL
DES MOINES
LINCOLN
CHICAGO
WASHINGTON
CEDAR RAPIDS
ROCKVILLE
STAMPS
RICHARDSON
LA
LA
NY
TX
GA
FL
IL
IN
IA
NE
IL
DC
IA
MA
AR
TX
71273
71137
10005
75240
30319
33733
60666
46082
50307
68501
60630
20006
52406
20850
71860
75083
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
11
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
BAROID (SELF-INSURED)
BAS LTD
BASF CORPORATION
BASIC BENEFITS GROUP
BATON ROUGE ROOFING & SHEET METAL ROOFERS 317
BATON ROUGE ROOFING & SHEET METAL ROOFERS 317
BAXTER HEALTH LINE
BAY OAKS HEALTH PLAN
BCS LIFE INS. CO.
BEALL-LADYMON CORPORTATION
BEAUREGARD ELECTRIC (SELF-INSURED)
BEAZER WEST INC INSURANCE DEPARTMENT
BECKER INDUSTRIES
BECKWITH, HIGHTOWER & REMBERG
1600-00
3260-00
2055-00
1698-00
1094-00
1042-00
1678-00
3309-00
0062-00
1555-00
2653-00
2056-00
0959-00
2950-00
HOUSTON
JACKSON
DETROIT
DENHAM SPRINGS
BATON ROUGE
BATON ROUGE
MILWAUKEE
TEXAS CITY
CHICAGO
SHREVEPORT
DERIDDER
DALLAS
HAHNVILLE
MIDDLETOWN
TX
MS
MI
LA
LA
LA
WI
TX
IL
LA
LA
TX
LA
NY
77205
39236
48232
70727
70806
70806
53226
77591
60611
71135
70634
75219
70057
10940
BEECH STREET
BEECH STREET
BEHAVIORAL HEALTH INC
1348-00
3752-00
2955-00
IRVINE
RICHARDSON
BATON ROUGE
CA
TX
LA
92713
75085
70808
BEHAVIORAL HEALTH SYSTEMS
BELL DEDICATED SERVICE CENTER
BELL NATIONAL LIFE INS. CO.
BELMONT CONSTRUCTORS INC
BEN-A-MED
BENE PLAN STRATEGIES
BENE-PRO BENEFIT AND MANAGED CARE PROFESSIONALS
BENEFICE
BENEFICIAL ASSOCIATION OF CONGRESSIONAL EMPLOYEES
BENEFICIAL EMPLOYEES SECURITY TRUST
BENEFICIAL LIFE INS. CO.
3779-00
1701-00
0072-00
2399-00
1618-00
1838-00
2452-00
3075-00
2458-00
2843-00
0073-00
BIRMINGHAM
BIRMINGHAM
GAITHERSBURG
JACKSON
WEST MONROE
DAYTON
PLYMOUTH
PISCATAWAY
VIENNA
NEWPORT BEACH
SALT LAKE CITY
AL
AL
MD
MN
LA
OH
MN
NJ
VA
CA
UT
35283
35283
20760
56143
71291
45401
55441
08854
22183
92658
84136
BENEFICIAL STANDARD LIFE INS. CO.
BENEFIT ADMIN. SYSTEMS LTD.IGA GRP. EMP.BENEFIT PROG.
BENEFIT ADMINISTRATION SERVICES
BENEFIT ADMINISTRATION SERVICES
BENEFIT ADMINISTRATION SERVICES,LTD
BENEFIT ADMINISTRATIVE SYSTEMS, LLC
BENEFIT ADMINISTRATORS
BENEFIT ADMINISTRATORS OF AMERICA
BENEFIT AMERICA
BENEFIT CLAIMS ADMINISTRATORS INC
BENEFIT CLAIMS PAYORS INC
BENEFIT CONCEPTS INC
BENEFIT CONTROL SERVICE CORP
BENEFIT COORDINATORS CORP
0074-00
1759-00
3860-00
3644-00
0868-00
3512-00
1937-00
1195-00
1539-00
1286-00
2443-00
2331-00
1281-00
3261-00
AMARILLO
ORLAND PARK
EAGEN
RICHLAND
JACKSON
HOMEWOOD
FORT MITCHELL
DES MOINES
TIFTON
TOLEDO
PHOENIX
VALHALLA
DENHAM SPRINGS
PITTSBURGH
TX
IL
MN
MS
MS
IL
KY
IA
GA
OH
AZ
NY
LA
PA
79105
60462
55121
39157
39236
60430
41017
50306
31793
43603
85069
10595
70726
15205
BENEFIT DATA ADMINISTRATORS
BENEFIT DESIGN & ADMINISTRATORS INC FOR WABASH
2346-00
1751-00
LARKSPUR
INDIANAPOLIS
CA
IN
94977
46256
BENEFIT INNOVATIONS LTD
BENEFIT MANAGEMENT INC
2969-00
1869-00
P O BOX 62107
P O BOX 14208
P O BOX 33168
P O BOX 758
2061 BEAUMONT DR
2061 BEAUMONT DR
P O BOX 26986
424 N TARPAY ROAD
676 NORTH ST. CLAIR
P O BOX 5756
P O DRAWER 970
P O BOX 190999
P O BOX 30
NPPN
P O BOX 5095
P O BOX 16609
P O BOX 853925
2431 S ACADIAN THRUWAY
STE 500
P O BOX 830724
P O BOX 830279
702 RUSSELL AVENUE
146 INDUSTRIAL PARK
410 WASHINGTON
P O BOX 1391
10405 6TH AVE NORTH #300
242 OLD NEW BROWNSWICK RD
P O BOX 6000
P O BOX 3100
36 SOUTH STATE STREET
BENEFICIAL LIFE TOWER
P O BOX 15047
43 ORLAND SQ. DR STE 303
P O BOX 21515
402 WEST PARKWAY PLACE
P O BOX 14208
17475 JOVANNA DRIVE
P O BOX 17808
P O BOX 9120
P O BOX 1268
P O BOX 1776
P O BOX 37400
P O BOX D
680 CENTERVILLE ST
100 RYAN COURT
STE 200
P O BOX 1059
NATIONAL CORP
P O BOX 5043
P O BOX 10006
P O BOX 3001
2660 E 32ND ST
PEORIA
JOPLIN
IL
MO
61612
64803
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
12
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
BENEFIT MANAGEMENT SERVICES
3902-00
RIDGELAND
MS
39157
BENEFIT
BENEFIT
BENEFIT
BENEFIT
BENEFIT
BENEFIT
BENEFIT
1321-00
3323-00
2042-00
1489-00
2297-00
1017-00
2350-00
613 CRESENT CIRCLE
SUITE 201
P O BOX 98044
P O BOX 2058
900 ISOM RD/STE 302
P O BOX 130217
P O BOX 52009
P O BOX 690450
3229 36TH STREET
STE 204
P O BOX 4138
P O BOX 2977
P O BOX 80447
400 FIELD DRIVE
P O BOX 6827
1710 FIRMAN/STE 400
P O BOX 37400
P O BOX 37400
P O BOX 24100
BOARD OF PENSIONS
1027 ARCH ST
P O BOX C-4900
FOURTH & BLANCHARD BLDG
SUIT 1450
P O BOX 19
P O BOX 921229
P O BOX 370
P O BOX 81189
5285 W LAKEVIEW PKWY
C/O HOOD INDUSTRIES
P O BOX 16767
10405 6TH AVE NORTH #300
P O BOX 15908
531 WEST 61ST ST
700 SOUTH STREET
P O BOX 20945
4201 BIRCH STREET
P O BOX 101387
P O BOX 101387
300 OXFORD DR
P O DRAWER 789
1300 HWY 165 BYPASS
P O BOX 9071
P O BOX 9407
720 BLAIR MILL RD
1515 RIVER OAKS ROAD EAST
P O BOX 250
P O BOX 162148
P O BOX 1460
P O BOX 8902
P O BOX 1807
BATON ROUGE
MADISON
SAN ANTONIO
TYLER
SHREVEPORT
SAN ANTONIO
METAIRIE
LA
MS
TX
TX
LA
TX
LA
70898
39130
78216
75713
71135
78269
70001
AKRON
GAINESVILLE
INDIANAPOLIS
LAKE FOREST
DOTHAN
RICHARDSON
PHOENIX
PHOENIX
GREENVILLE
PHILADELPHIA
OH
GA
IN
IL
AL
TX
AZ
AZ
SC
PA
44321
30503
46280
60045
36302
75081
85069
85069
29616
19107
SCOTTSDALE
SEATTLE
AZ
WA
85261
98121
MEMPHIS
NORCROSS
PUEBLO
LAFAYETTE
INDIANAPOLIS
JACKSON
TN
GA
CO
LA
IN
MS
38101
30092
81002
70598
46268
39236
PLYMOUTH
ROCKFORD
SHREVEPORT
PITTSFIELD
COLUMBUS
NEWPORT BEACH
FORT WORTH
FT WORTH
MONROEVILLE
RUSTON
MONROE
DUBLIN
JACKSON
HORSHAM
HARAHAN
LOCKPORT
ALTAMONTE SPRINGS
LITTLE ROCK
WICHITA
BRENHAM
MN
IL
LA
MA
OH
CA
TX
TX
PA
LA
LA
OH
MS
PA
LA
LA
FL
AR
KS
TX
55441
61132
71106
01201
43220
92660
76185
76185
15146
71270
71202
43017
39286
19044
70123
70394
32716
72203
67208
77833
MANAGEMENT SERVICES
MANAGEMENT SYSTEM
PAYROLL SYSTEM
PLAN ADMINISTRATORS
PLAN SERVICES
PLANNERS
RESOURCES ADMINISTRATIVE SERVICES INC
BENEFIT SERVICES INC
BENEFIT SUPPORT INC
BENEFIT SYSTEMS
BENEFIT TRUST LIFE INS. CO.
BENEFITS ADMINISTRATORS INC
BENEFITS ASSISTANCE
BENEFITS CLAIMS PAYORS
BENEFITS CLAIMS PAYORS
BENEFITS IN A CORD
BENEFITS PLAN OF THE PRESBYTERIAN CHURCH (USA)
3099-00
3322-00
2583-00
0075-00
2528-00
3108-00
1625-00
1742-00
3453-00
1980-00
BENEFITS RESOURCES INCORPORATED
BENEFITS TRUST
1153-00
2169-00
BENEFIX
BENESCRIPT
BENESIGHT
BENESYS INC/BASS ADMINISTRATORS
BENICORP INS. CO. OF INDIANA
BENMARK INC
2938-00
2866-00
3062-00
2245-00
1649-00
1626-00
BENO PRO
BERACAH MINISTRIES
BERG, INC. (SELF-INSURED)
BERKSHIRE LIFE INS. CO.
BERWANGER OVERMYER ASSOCIATES
BEST LIFE ASSURANCE CO. OF CA
BESTCARE NETWORK
BESTCARE NETWORK
BETTER HEALTH PLANS
BI-MED
BIEDENHARN BOTTLING CO.
BIG LOTS ASSOCIATE BENEFIT PLAN
BILL'S DOLLAR STORES MEDICAL BENEFITS
BLAIR MILL INTERCOUNTY HEALTH PLAN
BLESSEY ENTERPRISES
BLLINGER SHIPYARD EMPLOYEE HEALTH CARE
BLOSSMAN INC
BLUE ADVATAGE ADMINISTRATION OF AR
BLUE BEACON INTERNATIONAL INC
BLUE BELL BENEFITS TRUST
2234-00
3169-00
2416-00
0076-00
1921-00
0077-00
0030-13
3013-00
3222-00
2442-00
2511-00
3201-00
2192-00
2945-00
3312-00
2213-00
2263-00
3506-00
3114-00
1832-00
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
13
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
BLUE CARE NETWORK
BLUE CHOICE
BLUE CIRCLE DENTAL BENEFITS PLAN
2770-00
3032-00
2887-00
SAGINAW
ST LOUIS
NEWPORT
MI
MO
KY
48603
63166
41071
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
(REGENCE GROUP ADMIN)
& BLUE SHIELD OF NEBRASK
BLUE SHIELD
BLUE SHIELD OF AK
BLUE SHIELD OF GA
BLUE SHIELD OF GEORGIA
CALIFORNIA (ANTHEM)
FEB (ANTHEM)
OF ALABAMA
3797-00
3718-00
H014-70
4009-00
3652-00
4006-00
3610-00
3740-00
3463-00
BELLEVUE
OMAHA
BATON ROUGE
SEATTLE
COLUMBUS
ATLANTA
WOODLAND HILLS
RICHMOND
BIRMINGHAM
WA
NE
LA
WA
GA
GA
CA
VA
AL
98015
68180
70898
98111
31908
30348
91365
23279
35298
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
3876-00
0508-00
3756-00
0532-00
0548-00
3894-00
H584-90
3707-00
3693-00
3566-00
3558-00
3969-00
H056-40
0835-00
3708-00
1697-00
2888-00
0537-00
0979-00
3926-00
0541-00
1936-00
1234-00
0543-00
3583-00
0535-00
3840-00
0964-00
0539-00
3611-00
0837-00
2233-00
0540-00
3954-00
3732-00
3551-00
3681-00
4200 FASHION SQUARE BLVD
P O BOX 66834
ONE RIVERFRONT PLACK
SUITE 700
P O BOX 52890
P O BOX 3248
P O BOX 98029
P O BOX 91059
P O BOX 9907
P O BOX 105370
21555 QXUARD
P O BOX 27401
450 RIVER CHASE PKWY E
P O BOX 995
P O BOX 2294
P O BOX 830279
P O BOX 240609
P O BOX 13466
P 0 BOX 2417
P O BOX 2181
P O BOX 2417
P O BOX 1460
P O BOX 60007
P O BOX 272610
P O BOX 60007
P O BOX 54139
P O BOX 60007
P O BOX 5368
P O BOX 5747
P O BOX 1042
P O BOX 1991
P O BOX 1798
P O BOX 7368
P O BOX 105557
1333 CHESTNUT ST.
P O BOX 860
P O BOX 7408
300 E RANDOLPH
P O BOX 805107
233 N MICHIGAN AVE
P O BOX 23058
120 WEST MARKET ST
636 GRAND AVE
636 GRAND AVE
P O BOX 239
P O BOX 2956
9901 LINN STATION RD.
P O BOX 37690
P O BOX 36550
P O BOX 37180
P O BOX 261798
BIRMINGHAM
BIRMINGHAM
ANCHORAGE
PHOENIX
LITTLE ROCK
LITTLE ROCK
LITTLE ROCK
LITTLE ROCK
LOS ANGELES
CHICO
LOS ANGELES
LOS ANGELES
LOS ANGELES
DENVER
DENVER
NORTH HAVEN
WILMINGTON
JACKSONVILLE
COLUMBUS
ATLANTA
PHILADELPHIA
HONOLULU
BOISE
CHICAGO
CHICAGO
CHICAGO
BELLEVILLE
INDIANAPOLIS
DES MOINES
DES MOINES
TOPEKA
WICHITA
LOUISVILLE
LOUISVILLE
LOUISVILLE
LOUISVILLE
BATON ROUGE
AL
AL
AK
AZ
AR
AR
AR
AR
CA
CA
CA
CA
CA
CO
CO
CT
DE
FL
GA
GA
PA
HI
ID
IL
IL
IL
IL
IN
IA
IA
KS
KS
KY
KY
KY
KY
LA
35201
35283
99524
85002
72203
72203
72203
72203
90060
95927
90060
90054
90060
80217
80217
06473
19899
32231
31908
30348
19107
96808
83707
60601
60680
60601
62223
46204
50307
50309
66601
67201
40223
40233
40233
40233
70826
ALABAMA
ALABAMA
ALASKA (PREMERA)
ARIZONA
ARKANSAS
ARKANSAS (FEP
ARKANSAS (MED REPL)
ARKANSAS (WALMART)
CALIFORNIA
CALIFORNIA
CALIFORNIA (ANTHEM)
CALIFORNIA (ANTHEM)
CALIFORNIA (MED REPL)
COLORADO
COLORADO (ANTHEM DENVER)
CONNECTICUT
DELAWARE
FLORIDA
GEORGIA
GEORGIA (FEP)
GREATER PHILADELPHIA
HAWAII
IDAHO
ILLINOIS
ILLINOIS
ILLINOIS (CHICAGO)
ILLINOIS (DENTAL)
INDIANA
IOWA
IOWA (WELLMARK)
KANSAS
KANSAS (BOEING)
KENTUCKY
KENTUCKY (ANTHEM)
KENTUCKY (ANTHEM)
KENTUCKY (ANTHEM)
LOUISIANA
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
14
TPL CARRIER FILE LISTING
CARRIER NAME
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
LOUISIANA
LOUISIANA (FEP)
MAINE
MARYLAND
MASSACHUSETTS
MASSACHUSETTS
MICHIGAN
MICHIGAN (MED REPL)
MINNESOTA
MISSISSIPPI
MISSOURI (ANTHEM)
MISSOURI (ANTHEM)
MISSOURI (ANTHEM)
MISSOURI (KC)
MISSOURI (ST LOUIS)
MONTANA
MONTANA
NEBRASKA
NEVADA
NEW HAMPSHIRE
NEW JERSEY
NEW JERSEY (EXCELLUS)
NEW JERSEY (MED REPL)
NEW MEXICO
NEW YORK
NEW YORK (AT & T)
NEW YORK (EMPIRE)
NEW YORK (EXCELLUS)
NEW YORK (NORTHEASTERN)
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
0546-00
2601-00
1405-00
0542-00
0545-00
3742-00
0544-00
H231-90
1708-00
0515-00
1366-00
3503-00
3502-00
1251-00
0533-00
3971-00
2441-00
1402-00
2051-00
2672-00
0947-00
3451-00
H315-40
2916-00
0741-00
1836-00
0928-00
3809-00
0536-00
P O BOX 98029
P O BOX 98029
P O BOX 8884
700 E JOPPA ROAD
100 HANCOCK ST
P O BOX 986015
600 LAFAYETTE EAST
P O BOX 440
P O BOX 64061
P O BOX 1043
P O BOX 14882
P O BOX 14882
P O BOX 14882
P O BOX 419169
444 FOREST PARK
P O BOX 7982
P O BOX 50004
P O BOX 3248
P O BOX 10330
3000 GOFFS FALLS RD
PO BOX 420
165 COURT ST
3 PENN PLAZA
P O BOX 27630
PO BOX 3850 GRAND CENTRAL
75 CRYSTAL RUN ROAD
P O BOX 5069
P O BOX 22999
1251 NEW SCOTLAND ROAD
P O BOX 8650
343 STATE ST
298 MAIN ST
P O BOX 80
P O BOX 35
4510 13TH AVE SW
P O BOX 182042
P O BOX 94754
9075 CENTRE POINT DRIVE
SUITE 200
P O BOX 105187
P O BOX 943
1351 WILLIAM HOWARD TAFT
P O BOX 3283
1215 SOUTH BOULDER
P O BOX 1271
P O BOX 226
P O BOX 890713
2500 ALBERTINE AVE
P O BOX 890062
P O BOX 3355
P O BOX 2085
BATON ROUGE
BATON ROUGE
PORTLAND
BALTIMORE
NORTH QUINCY
BOSTON
DETROIT
SOUTHFIELD
ST PAUL
JACKSON
SAINT LOUIS
ST LOUIS
ST LOUIS
KANSAS CITY
ST LOUIS
HELANA
BUTTE
OMAHA
RENO
MANCHESTER
NEWARK
ROCHESTER
NEWARK
ALBUQUERQUE
NEW YORK
MIDDLETON
MIDDLETOWN
ROCHESTER
ALBANY
LA
LA
ME
MD
MA
MA
MI
MI
MN
MS
MO
MO
MO
MO
MO
MT
MT
NE
NV
NH
NJ
NY
NJ
NM
NY
NY
NY
NY
NY
70898
70898
04104
21204
02171
02298
48226
48037
55164
39205
63178
63178
63178
64141
63108
59604
59701
68180
89520
03111
07101
14647
07105
87125
10017
10943
10940
14692
12208
ROCHESTER
BUFFALO
NY
NY
14650
14240
DURHAM
FARGO
COLUMBUS
CLEVELAND
WESTCHESTER
NC
ND
OH
OH
OH
27702
58121
43218
44101
45069
ATLANTA
TOLEDO
CINCINNATI
TULSA
TULSA
PORTLAND
PITTSBURGH
CAMP HILL
HARRISBURG
CAMPHILL
PITTSBURGH
PITTSBURGH
GA
OH
OH
OK
OK
OR
PA
PA
PA
PA
PA
PA
30348
43656
45206
74102
74119
97207
15222
17089
17177
17089
15230
15230
BLUE CROSS OF NEW YORK (ROCHESTER)
BLUE CROSS OF NEW YORK (WESTERN)
1023-00
0746-00
BLUE
BLUE
BLUE
BLUE
BLUE
CROSS
CROSS
CROSS
CROSS
CROSS
OF
OF
OF
OF
OF
NORTH CAROLINA
NORTH DAKOTA
OHIIO (CENTRAL)
OHIO
OHIO (ANTHEM)
1058-00
3181-00
1568-00
2693-00
3448-00
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OHIO (ANTHEM)
OHIO (NORTHWEST)
OHIO (SOUTHWEST)
OKLAHOMA
OKLAHOMA
OREGON
PENNSYLVANIA
PENNSYLVANIA
PENNSYLVANIA
PENNSYLVANIA (ANTHEM)
PENNSYLVANIA (HGHMRK)
PENNSYLVANIA (HGHMRK)
3993-00
0534-00
1163-00
3861-00
2691-00
1270-00
3907-00
1657-00
2081-00
3867-00
3498-00
3726-00
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
15
TPL CARRIER FILE LISTING
CARRIER NAME
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
PENNSYLVANIA (IND)
PENNSYLVANIA (NORTH EAST)
PENNSYLVANIA HIGHMARK
PENNSYLVANIA HIGHMARK
PENNSYLVANIA HIGHMARK
RHODE ISLAND
RHODE ISLAND (MEDICARE REPL)
SOUTH CAROLINA
SOUTH CAROLINA
SOUTH CAROLINA
SOUTH CAROLINA
SOUTH CAROLINA
SOUTH DAKOTA
TENNESSEE
TENNESSEE
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
3481-00
1358-00
3986-00
3985-00
4003-00
1158-00
H415-20
3978-00
3976-00
3974-00
0968-00
3492-00
3145-00
0880-00
3950-00
1901 MARKET ST
70 N MAINE STREET
PO BOX 890382
PO BOX 69352
P O BOX 1210
444 WESTMINSTER MALL
444 WESTMINSTER ST
P O BOX 6000
P O BOX 100300
P O BOX 100121
I-20 EAST ALPINE ROAD
P O BOX 100605
1601 WEST MADISON
801 PINE ST
1 CAMERON HILL CIR
SUITE #0002
P O BOX 98
1800 WEST LOOP SOUTH
6TH FLOOR
POST OFFICE BOX 225730
P O BOX 66044
901 S CENTRAL
P O BOX 795180
P O BOX 30270
P O BOX 186
2015 STAPLES MILL RD
P O BOX 91015
1114 BROADWAY PLAZA
P O BOX 91059
P O BOX 327
550 12TH ST SW
811 GRAND CENTRAL AVE
BOX 5556
401 W MICHIGAN STREET
N17 W24340 RIVERWOOD DR
P O BOX 105187
P O BOX 7026
P O BOX 2266
1215 SOUTH BOULDER
P O BOX 3283
P O BOX 358.
P O BOX 363628
P O BOX 98018
BOX 41948
2425 NOWATA PLACE
P O BOX 250
P O BOX 20945
754 MINNESOTA AVE
SUITE 522
P O BOX 61
P O BOX 727
PHILADELPHIA
WILKES-BARRE
CAMP HILL
HARRISBURG
PITTSBURGH
PROVIDENCE
PROVIDENCE
GREENVILLE
COLUMBUS
COLUMBUS
COLUMBIA
COLUMBIA
SIOUX FALLS
CHATTANOOGA
CHATTANOOGA
PA
PA
PA
PA
PA
RI
RI
SC
SC
SC
SC
SC
SD
TN
TN
19101
18711
17089
17106
15230
02901
02903
29606
29202
29201
29219
29260
57104
37402
37402
MEMPHIS
HOUSTON
TN
TX
38101
77027
DALLAS
DALLAS
RICHARDSON
SAN ANTONIO
SALT LAKE CITY
MONTPELIER
RICHMOND
SEATTLE
TACOMA
SEATTLE
SEATTLE
WASHINGTON
VIENNA
TX
TX
TX
TX
UT
VT
VA
WA
WA
WA
WA
DC
WV
75265
75266
75080
78272
84130
05601
23279
98111
98402
98111
98111
20224
26105
MILWAUKEE
WAUKESHA
ATLANTA
WHEELING
CHEYENNE
TULSA
WI
WI
GA
WV
WY
OK
53201
53188
30348
26003
82001
74102
PITTSBURGH
SAN JUAN
BATON ROUGE
KANSAS CITY
BARTLESVILLE
LOCKPORT
COLUMBUS
KANSAS CITY
PA
PR
LA
MO
OK
LA
OH
KS
15230
00936
70898
64141
74006
70374
43220
66101
BOISE
SHORT HILLS
ID
NJ
83707
07078
BLUE CROSS OF TENNESSEE (MEMPHIS)
BLUE CROSS OF TEXAS
0972-00
4002-00
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
0520-00
3537-00
3680-00
3585-00
1818-00
2856-00
1006-00
1276-00
2266-00
3672-00
1196-00
0742-00
1432-00
BLUE
BLUE
BLUE
BLUE
BLUE
BLUE
CROSS
CROSS
CROSS
CROSS
CROSS
CROSS
OF WISCONSIN
OF WISCONSIN (ANTHEM)
OF WISCONSIN (ANTHEM)
OF WV(MOUNTAIN ST)
OF WYOMING
OKLAHOMA
0740-00
3998-00
3895-00
3874-00
1190-00
0521-00
BLUE CROSS PENNSYLVANIA (WESTERN)
BLUE SHIELD OF PUERTO RICO
BLUEBONNET ADMINISTRATORS
BMA-DAIRYMEN INC
BMI-HEALTH PLANS
BO LLINGER EMPLOYEE HEALTH CARE PLAN
BOA EMPLOYEE BENEFITS
BOILERMAKERS NATIONAL HEALTH & WELFARE FUND
0538-00
2822-00
1677-00
1953-00
3096-00
1713-00
1508-00
0874-00
BOISE CASCADE CORP
BOLLINGER EMPLOYEES HEALTH PLAN
1174-00
3849-00
TEXAS
TEXAS
TEXAS
TEXAS (ANTHEM)
UTAH
VERMONT
VIRGINIA
WASHINGTON (KING COUNTY MEDICAL)
WASHINGTON (PIERCE COUNTY MEDICAL)
WASHINGTON (PREMERA)
WASHINGTON & ALASKA
WASHINGTON DC
WEST VIRGINIA
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
16
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
BOLLINGER EMPLOYEES HEALTHCARE PLAN
BOLLINGER EMPLOYEES HEALTHCARE PLAN
BOON CHAPMAN
BORAL BRICKS INC
BORDEN HEALTH CARE
3729-00
2264-00
0971-00
2510-00
0943-00
SHORT HILLS
LOCKPORT
AUSTIN
AUGUSTUS
COLUMBUS
NJ
LA
TX
GA
OH
07078
70374
87866
30913
43216
BORG-WARNER CHEMICALS,INC
BOSSIER MEDICAL CENTER EMPLOYEE BENEFIT TRUST
BOSSIER PARISH SCHOOL BOARD
BOSTON MUTUAL LIFE INS. CO.
BOYD BROTHERS TRANSPORTATIONS INC
BOYD GAMING CORPORATION CENTRAL REGION EMPLOYEES
1300-00
1750-00
2138-00
0078-00
3226-00
2939-00
WAVELAND
BOSSIER CITY
BENTON
CANTON
CLAYTON
LAS VEGAS
MS
LA
LA
MA
AL
NV
39576
71111
71006
02021
36016
89109
BOYS & GIRLS CLUB INSURANCE TRUST
2949-00
DES MOINES
IA
50309
BRADFORD NATIONAL LIFE INS. CO.
0079-00
LEXINGTON
KY
40503
BRADLEY AND COKER
BRAVO HEALTH
BRAVO HEALTH
BREAVELL CLAIMS MANAGEMENT
BREMCO
BRICKLAYERS LOCAL UNION NO.1 (SELF INSURED)
BRIDGEFIELD CASUALTY INSURANCE CO
BRIDGESTONE AMERICAS HOLDING INC
BRISTOL-MYERS SQUIBB CARDIOVASCULAR ACCESS PROGRAM
BROADREACH MEDICAL RESOURCES
2600-00
3690-00
H452-80
2459-00
0807-00
0955-00
3292-00
3188-00
2660-00
4112-00
LITTLE ROCK
EL PASO
EL PASO
BROOKFIELD
BOSSIER CITY
NEW ORLEANS
LAKELAND
JAMESVILLE
MCLEAN
NEW YORK
AR
TX
TX
WI
LA
LA
FL
WI
VA
NY
72221
79998
79998
53008
71111
70116
33802
53547
22102
10018
BROKERAGE CONCEPTS
3931-00
BLUE BELL
PA
19422
BROKERAGE CONCEPTS OF DELAWARE
BROKERS NATIONAL LIFE INSURANCE COMPANY
BROOKFIELD S.I.B.S.
3228-00
3024-00
1308-00
WARMINSTER
HOUSTON
PARK RIDGE
PA
TX
IL
18974
77251
60068
BROOKSHIRE BROTHERS
BROWN & BROWN INC
BROWN AND ROOT INC
BROWN FORMAN CORPORATION
BROWN GROUP INSURANCE
BROWNING AMBULANCE AND HEALTH SERVICES INC
BROWNING FERRIS INDUSTRY (SELF-INSURED)
BRUCE FOOD'S CORP MEDICAL BENEFITS TRUST
BUCK EYE LIQUOR CO(SELF-INSURED)
BUILDING TRADE ASSOCIATION HEALTH CARE PLAN
2069-00
3104-00
0926-00
2927-00
1244-00
0810-00
2038-00
1995-00
1257-00
2159-00
LUFKIN
DAYTONA BEACH
HOUSTON
LOUISVILLE
ST LOUIS
DENHEM SPRINGS
LAFAYETTE
NEW IBERIA
DALLAS
FREMONT
TX
FL
TX
KY
MO
LA
LA
LA
TX
CA
75902
32115
77292
40201
63166
70726
70505
70562
75229
94538
BUNKIE BANK & TRUST CO., (SELF-INSURED)
BUPA INTERNATIONAL
2001-00
3057-00
BUNKIE
MIAMI
LA
FL
71322
33131
BURGER KING CORPORATION
BURGETT & DIETRICH
BURHAM SERVICE CORP EMPLOYEE HEALTH PLAN
1395-00
2348-00
1969-00
P O BOX 706
P O BOX 250
P O BOX 9201
P O BOX 1957
ADMIN. SERVICES UNIT
PO BOX 189
P O BOX N
2105 AIRLINE DR
P O BOX 2000
120 ROYALL STREET
P O BOX 70
BENEFIT PLAN
2950 INDUSTRIAL RD
100 COURT AVE
SUITE 306
771 CORPORATE DRIVE
STE. 201
P O BOX 8200
P O BOX 981706
P O BOX 981706
P O BOX 846
1975 OLD MINDEN RD
1407 DECATUR ST
P O DRAWER 988
P O BOX 5224
P O BOX 9445
1350 BROADWAY
SUITE 410
801 LAKEVIEW DR
SUITE 301
P O BOX 2843
P O BOX 1028
SELF INSURED BENEFIT SERV
1030 HIGGINS RD
P O BOX 1688
P O BOX 2480
P O BOX 922001
P O BOX 1080
P O BOX 29
P O BOX 1052
P O BOX 52453
P O BOX 1030
2580 WALNUT HILL LANE
39420 LIBERTY ST
SUITE 260
BOX 100
600 BRICKELL AVE
SUITE 701
P O BOX 40
P O BOX 8002
P O BOX 7966
MINNEAPOLIS
LITTLE ROCK
COLUMBUS
MN
AR
GA
55440
72203
31908
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
17
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
BURNS INTERNAT'L HEALTH & WELFARE FUND
BUSINESS ADMINISTRATORS AND CONSULTANTS INC
BUSINESS MANAGEMENT SERVICES
BUSINESS MEN'S ASSUR. CO. OF AMERICA
BUTLER BENEFIT SERVICE INC
C & A CONTINENTAL INS
C B A G T ADMINISTRATION
C C SYSTEMS CORPORATION OF TEXAS
2328-00
2952-00
2171-00
0080-00
3761-00
1047-00
1410-00
1204-00
FREMONT
REYNOLDSBURG
ALEXANDRIA
KANSAS CITY
DAVENPORT
PASADENA
PENSACOLA
HOUSTON
CA
OH
LA
MO
LA
TX
FL
TX
94538
43068
71303
64141
52808
77502
32507
77002
C D S GROUP HEALTH
C R ANTHONY COMPANY (SELF INSURED)
C.A.M.E. C.O. INDUSTRIES
CADDO RETIRED INSURANCE PLAN
CADDO-BOSSIER ASSOCIATION OF RETARDED CITIZENS
CADILLAC INSURANCE CO
CAJUN BAG & SUPPLY CO (SELF-INSURED)
CAJUN CHEF PRODUCTS INC
CAL-MAINE FOODS
CALCASIEU MARINE NATIONAL BANK(SELF-INSURED)
CALCASIEU MARINE NATIONAL BANK-SELF FUNDED HEALTH INS
CALCASIEU PARISH SCHOOL BOARD
CALCASIEU PARISH SHERIFF DEPARTMENT
CALIFORNIA IRONWORKERS FIELD WELFARE PLAN
CALIFORNIA LIFE INS. CO.
CALIFORNIA PACIFIC INSURANCE SERVICES INC
CALIFORNIA WESTERN MANAGEMENT BENEFIT TRUST FUND
CALIFORNIA-WESTERN STATES LIFE INS. CO.
CAM ADMINISTRATIVE SERVICES,INC
CAMBRIDGE INTERGRATED SVCS(FORMERLY PRESIDIUM INC)
CAMCO INTERNATIONAL INC
CAMECO GROUP BENEFITS
CAMELOT HEALTHCARE LLC
CAMPBELL TAGGART INC/RAINBO BAKING CO
3012-00
1450-00
1263-00
2077-00
2358-00
1731-00
2256-00
2238-00
0954-00
2193-00
2206-00
1822-00
1939-00
0855-00
0081-00
1132-00
2031-00
0082-00
2344-00
3092-00
2388-00
2189-00
3140-00
1252-00
SPARKS
OKLAHOMA CITY
JEANERETTE
SHREVEPORT
SHREVEPORT
FARMINGTON HILLS
CROWLEY
ST.MARTINVILLE
WALKER
LAKE CHARLES
LAKE CHARLES
LAKE CHARLES
LAKE CHARLES
SAN MARINO
LOS ANGLES
TUSTIN
FREEMONT
SACRAMENTO
SOUTHFIELD
PASSIPPANY
GRAY
THIBODAUX
RAYNE
DALLAS
NV
OK
LA
LA
LA
MI
LA
LA
LA
LA
LA
LA
LA
CA
CA
CA
CA
CA
MI
NJ
LA
LA
LA
TX
89435
73125
70544
71135
71101
48018
70526
70582
70785
70702
70602
70602
70602
91108
90010
92681
94537
95814
48086
07054
70359
70302
70578
75266
CANADA LIFE
CANADA LIFE ASSURANCE CO., THE
3204-00
0083-00
BUFFALO
ONTARIO
NY
ON
14240
00000
CANNON EXPRESS GROUP BENEFITS
CANNON, COCHRAN, MANAGEMENT SERVICE
CAPITAL BLUE CROSS
CAPITAL SERVICES CORPORATION
CAPITOL ADMINISTRATORS
CAPITOL AMERICAN LIFE INS. CO.
CAPITOL CARE
CAPITOL LIFE INS. CO., THE
CAPITOL MANUFACTURING EMPLOYEE BENEFIT CORP
CAPITOL STEEL, INC
CAPP CARE HEALTH CHOICE
CAPROCK HEALTH PLANS
CARBO CERAMICS INC
2988-00
0032-10
4127-00
1424-00
3011-00
0084-00
2225-00
0085-00
0966-00
1770-00
2472-00
3955-00
2896-00
39420 LIBERTY/STE 260
P O BOX 107
1006 CALAIS CIRCLE
BUSINESS MEN'S ASSURANCE
P O BOX 3310
213 WESTMORE STE 305
3420 BARRACAS AVE
SUITE 2120
440 LOUISIANA STREET
P O BOX 50190
P O BOX 25725
P O BOX 620
P O BOX 52009
351 JORDAN
31155 NORTHWESTERN HWY
115 WEST 1ST ST
P O BOX 248
PO BOX 100
P O BOX 3402
P O BOX 3402
P O BOX 3090
P O BOX V
475 HUNTINGTON DRIVE
3255 WILSHIRE BLVD.
P O BOX 1827
P O BOX 820
POST OFFICE BOX 959
P O BOX 5131
P O BOX 365
P O BOX 818
P O BOX 968
201 E LOUISIANA AVE
6211 LEMMON AVE
P O BOX 660217
P O BOX 1379
330 UNIVERSITY AVENUE
TORONTO 1
P O BOX 364
P O BOX 6794
2500 ELEMERTON AVE
P O BOX 10681
P O BOX 346
1001 LAKESIDE AVE
P O BOX 6000
POST OFFICE BOX 1200
1125 CAPITOL AVENUE
P O BOX 66636
P O BOX 271080
P O BOX 21548
EMPLOYEE'S BENEFIT PLAN
P O BOX 619110
SPRINGDALE
METAIRIE
HARRISBURG
JACKSON
ALPHARETTA
CLEVELAND
VIENNA
DENVER
CROWLEY
BATON ROUGE
FLOWER MOUND
EGAN
DALLAS
AR
LA
PA
MS
GA
OH
VA
CO
LA
LA
TX
MN
TX
72765
70009
17110
39206
30009
44114
22183
80201
70526
70896
75028
55121
75261
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
18
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
CARDINAL WIRELINE (SELF-INSURED)
CARE AMERICA
CARE CHOICES
CARE IMPROVEMENT PLUS
CARE IMPROVEMENT PLUS OF MARYLAND
2086-00
1214-00
3358-00
H652-80
H566-50
NEW IBERIA
CONROE
FARMINGTON
LINTHICUM
BALTIMORE
LA
TX
MO
MD
MD
70562
77305
48333
21090
21201
CARE MARK
CARE SCAN
CARE-N-TRUST
CAREFIRST
CAREFIRST (BLUE CROSS)
CAREINGTON INTERNATIONAL
CAREMARK
CAREMORE
2308-00
1576-00
2325-00
3340-00
3792-00
3009-00
3744-00
3913-00
LINCOLNSHIRE
CLEARWATER
JACKSON
OWINGS MILL
LEXINGTON
DALLAS
PHOENIX
CERRITOS
IL
FL
MS
MD
KY
TX
AZ
CA
60069
34617
39236
21117
40512
75240
85072
90703
CAREMORE
CAREPLUS HEALTH PLAN
CAREPLUS HEALTH PLANS INC
CARESOURCE
CARESTREAM SCRIP
CARITEN HEALTH CARE
CARNATION COMPANY,THE
H054-40
4108-00
H101-00
4119-00
2767-00
3225-00
0938-00
ARTESITA
MIAMI
LEXINGTON
DAYTON
SALT LAKE CITY
KNOXVILLE
HOUSTON
CA
FL
KY
OH
UT
TN
TX
90702
33172
40512
45402
84107
37933
77069
CAROLINA BENEFIT ADMINISTRATORS
3131-00
SPARTANBURG
SC
29304
CARPENTER HEALTH & WELFARE FUND LOCAL #953
1400-00
LAKE CHARLES
LA
70601
CARPENTER'S LOCAL 1098 FRINGE BENEFITS FUNDS
CARPENTERS HEALTH & SECURITY TRUST
CARPENTERS HEALTH & WELFARE TRUST-SOUTHERN CALIFORNIA
CARPENTERS LOCAL UNION INS. & PENSION PROGRAM
CARPENTERS LOCAL UNION 1811 HLT & WELFARE PLAN
CARPENTERS LOCAL 1897 - HEALTH AND WELFARE FUND
CARPENTERS REGIONAL COUNCIL
CARPENTERS UNION LOCAL 1846
1465-00
3723-00
2161-00
0531-00
0795-00
1444-00
1945-00
0504-00
BATON ROUGE
SEATTLE
LOS ANGELES
BATON ROUGE
MONROE
STERLINGTON
BATON ROUGE
NEW ORLEANS
LA
WA
CA
LA
LA
LA
LA
LA
70814
98111
90076
70805
71211
71280
70814
70116
CARRON & BLACK BENEFITS INC
CARTER'S INSURANCE
CASEMARK CLAIMS DEPARTMENT
CASINO AMERICA INC
CATALYST RX
2228-00
2489-00
3513-00
2741-00
3416-00
NASHVILLE
CENTREVILLE
SAN ANTONIO
NEW ORLEANS
ROCKVILLE
TN
MS
TX
LA
MD
37202
39631
78268
70152
20850
CATALYST RX
3390-00
ROCKVILLE
MD
20850
CATALYST RX
CATALYST RX
CATAMARAN
CATAMARANRX
CATERPILLAR,INC
CATHOLIC DAUGHTERS OF AMERICA
CATHOLIC GOLDEN AGE INSURANCE
3220-00
3896-00
3960-00
4022-00
1374-00
1406-00
0862-00
P O DRAWER 9350
P O BOX 3043
P O BOX 9082
P O BOX 488
351 WEST CAMDEN ST
STE 100
P O BOX 800
P O BOX 899
P O BOX 16707
10455 MILL RUN CIRCLE
P O BOX 14116
13155 NOEL RD
P O BOX 52196
12900 PARK PLAZA DR
SUITE 150
P O BOX 366
11430 NW 20TH ST
P O BOX 14697
230 N MAIN ST
448 E 6400 S SUITE 400
P O BOX 22987
5625 FM 1960 W
SUITE 317
P O BOX 3257
333 SOUTH PINE STREET
ADMINISTRATIVE SERVICES
1715 COMMON ST
(WELFARE & PENSION)
P O BOX 1029
P O BOX 76827
5219 CHOCTAW DR.
P O BOX 4617
P O BOX 812
8875 GREENWELL SPRINGS RD
PENSION SERVICE
1407 DECATUR ST.
289 PLUE PARK BLVD
P O BOX 610
P O BOX 686005
P O BOX 56549
800 KING FARM BLVD
4TH FLOOR
800 KING FARM BLVD
4TH FLR
P O BOX 44036
P O BOX 1069
P O BOX 545
P O BOX 20947
100 N E ADAMS STREET
14325 WILLARD RD
400 LACKAWANNA AVENUE
BATON ROUGE
ROCKVILLE
DEERFIELD
COVINGTON
PEORIA
CHANTILLY
SCRANTON
LA
MD
IL
LA
IL
VA
PA
70804
20849
60015
70433
61629
22021
18503
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
19
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
CATHOLIC KNIGHTS OF AMERICA, THE
CBA BLUE
CBCA ADMINISTRATORS
CBCA ADMINISTRATORS
CBCA ADMINISTRATORS
CBCA ADMINISTRATORS
CBI EQUIFAX GROUP BENEFITS
CBPI CLIAM FIDUCIARY ACCOUNT
0798-00
3850-00
3780-00
3701-00
3429-00
3305-00
0924-00
3579-00
ST LOUIS
S BURLINGTON
PLANO
MINNEAPOLIS
BEATTYVILLE
SAVANNAH
ATLANTA
TAMPA
MO
VT
TX
MN
KY
GA
GA
FL
63139
05407
75025
55440
41311
31416
30309
33623
CCEBT (CARLSON COMPANY EMPLOYEE BENEFIT TRUST)
CCMSI
CEIBA - GEIGY
CELTIC INS CO
CELTIC INSURANCE COMPANY
CELTIC INSURANCE COMPANY
0950-00
3210-00
1197-00
3814-00
3848-00
3914-00
MINNEAPOLIS
METAIRIE
ST GABRIEL
INDIANAPOLIS
LITTLE ROCK
CHICAGO
MN
LA
LA
IN
AR
IL
55440
70009
70776
46203
72221
60606
CELTIC LIFE INS. CO.
0086-00
CHICAGO
IL
60604
CELTIC SHORT TERM HEALTH
CEMENT MASON'S LOCAL #567 HEALTH & WELFARE PLAN
CENAC TOWING CO INS
CENTENNIAL LIFE INS. CO., THE
CENTRA
CENTRAL & SOUTHWEST SYSTEM MEDICAL PLAN
3845-00
2435-00
2000-00
0087-00
2352-00
0908-00
CAROL STREAM
NEW ORLEANS
HOUMA
OVERLAND PARK
PLANO
SHREVEPORT
IL
LA
LA
KS
TX
LA
60197
70127
70361
66201
75086
71156
CENTRAL BANK
CENTRAL BENEFITS
CENTRAL BENEFITS NATIONAL INSURANCE CO.
2244-00
2417-00
1593-00
SHREVEPORT
PLANO
MEMPHIS
LA
TX
TN
71137
75086
38111
CENTRAL
CENTRAL
CENTRAL
CENTRAL
CENTRAL
CENTRAL
CENTRAL
CENTRAL
CENTRAL
2924-00
0875-00
0088-00
2834-00
0089-00
0090-00
0091-00
4013-00
0090-01
3525 HAMPTON AVENUE
P O BOX 2365
P O BOX 251369
P O BOX 1339
P O BOX 902
P O BOX 16579
1600 PEACHTREE NW
FAIRMONT SPECIALTY GROUP
P O BOX 26222
PO BOX 1755
P O BOX 6794
P O BOX 11
P O BOX 33839
P O BOX 26440
233 W WACKER DR
STE 700
208 S LASALLE STREET
STE. 1644
P O BOX 4136
10054 I-10 SERVICE RD E
P O BOX 2617
POST OFFICE BOX 470
P O BOX 869043
C/O SWEPCO
PO BOX 21106
P O BOX 70100
P O BOX 869043
C/O PITTMAN & ASSOCIATES
P O BOX 116047
P O BOX 2638
PO BOX 5922
400 BENEFICIAL CENTER
17800 ROYALTON RD
POST OFFICE BOX 2488
POST OFFICE DRAWER 151
POST OFFICE BOX 34350
P O BOX 10815
SOUTHEAST & SOUTHWEST DIV
P O BOX 323
P O BOX 5116
WORTHAM TOWER 6TH FLOOR
2727 ALLEN PARKWAY
P O BOX 925309
207 NINTH STREET
P O BOX 2256
P O BOX 4065
9201 WATSON RD/STE 350
HUMAN RESOURCES DEPT
P O BOX 4065
P O BOX 165750
14724 VENTURA BLVD.
WACO
MADISON
PEAPACK
STRONGVILLE
FORTH WORTH
ALEXANDRIA
OMAHA
CLEARWATER
DES PLAINES
TX
WI
NJ
OH
TX
LA
NE
FL
IL
76702
53705
07997
44136
76101
71301
68134
33757
60017
DESPLAINES
HOUSTON
IL
TX
60017
77019
HOUSTON
DES MOINES
GRAPEVINE
MONROE
ST LOUIS
MONROE
TX
IA
TX
LA
MO
LA
77292
50307
76099
71211
63126
71201
KANSAS CITY
SHERMAN OAKS
MO
CA
64117
91403
FREIGHT LINES EMPLOYEES SECURITY PLAN
LIFE ASSURANCE CO
NATIONAL LIFE INS. CO. OF OMAHA, THE
RESERVE LIFE HEALTH INSURANCE
SECURITY LIFE INS. CO.
STATE LIFE INS. CO.
STATES HEALTH & LIFE CO. OF OMAHA
STATES INDEMNITY
STATES INS CO -
CENTRAL STATES SE AND SW AREAS
CENTRAL UNITED INSURANCE CO.
1012-00
2595-00
CENTRAL UNITED LIFE
CENTURION LIFE INS. CO.
CENTURY HEALTHCARE
CENTURY MEDICAL BANKERS LIFE & CASUALTY
CENTURY PLANNERS
CENTURY TELEPHONE ENTERPRISE
3854-00
0092-00
3489-00
0794-00
3221-00
1079-00
CERNER HEALTH PLANS
CERTIFIED LIFE INS. CO.
3980-00
0093-00
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
20
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
CF&I RETIREES, VEBA
3580-00
PITTSBURGH
PA
15222
CFB DREDGING CO-SELF-INSURED
CHA HEALTH
CHAIN ELECTRIC - SELF INSURED
CHAMPION HEALTH INSURANCE FUND
CHAMPION INTERNATIONAL CORPORATION
3405-00
3267-00
3516-00
3035-00
1463-00
NEW ORLEANS
LEXINGTON
AUSTIN
HUNTIN
HAMILTON
LA
KY
TX
VA
OH
70130
40523
78766
25728
45020
CHAMPIONS LIFE
CHAMPUS/TRICARE
CHAMPVA
CHANDLER & ASSOCIATES
2278-00
0518-00
3339-00
2457-00
RICHARDSON
MADISON
DENVER
AURORA
TX
WI
CO
OH
75081
53707
80246
44202
CHARLYN ENTERPRISES
CHARMING SHOPPES RX DRUG PLAN
CHART HOUSE INC.
CHARTER NATIONAL LIFE INS. CO.
CHEC INSURANCE
CHER A. BUMPS AND ASSOCIATES
CHEROKEE INSURANCE COMPANY
CHEROKEE NATIONAL LIFE INS. CO.
CHESAPEAKE LIFE INS. CO., THE
CHESTERFIELD RESOURCES INC
CHEVYLAND INSURANCE
CHICAGO PROVINCE MEDICAL PLAN
3313-00
1655-00
0525-00
0094-00
3028-00
2962-00
4110-00
0095-00
0096-00
1350-00
2585-00
3545-00
WINNS BORO
PHOENIX
LAFAYETTE
CLAYTON
GRAND PRAIRIE
OKLAHOMA CITY
WARREN
MACON
BALTIMORE
AKRON
SHREVEPORT
BAY ST LOUIS
LA
AZ
LA
MO
TX
OK
MI
GA
MD
OH
LA
MS
71295
85072
70502
63105
75053
73154
48090
31201
21202
44309
71103
38520
CHILDREN'S HOSPITAL HEALTH PLAN
CHITIMACHA EMPLOYEES HEALTH PLAN
CHOICE BENEFIT ASSOCIATION
CHOICE BRANDS INC
CHOICE CARE MANAGED SYSTEM INC
CHOICE NATIONAL
CHOICE NET INTERCARE
CHOICE PLAN MEMBER
1643-00
2774-00
2979-00
2538-00
2378-00
3529-00
3187-00
2718-00
NEW ORLEANS
CHARENTON
TIGARD
SHREVEPORT
MELVILLE
LEXINGTON
ENGLEWOOD
METAIRIE
LA
LA
OR
LA
NY
KY
CO
LA
70118
70523
97281
71137
11747
40512
80155
70005
CHOICE PLUS ERISA ADMINISTRATIVE SERVICES
2783-00
PHOENIX
AZ
85016
CHOUEST GROUP HEALTH PLAN
CHRISTIAN BROTHERHOOD
CHRISTIAN BROTHERS
CHRISTIAN CARE MEDI-SHARE
CHRISTIAN FIDELITY LIFE INS COMPANY
CHRISTIAN HEALTH MINISTRIES
CHRISTIAN HOSPITALIZATION AID
CHRISTUS ASSOCIATE HEALTH
CHRISTUS HEALTH/TEXAS TRUE CHOICE
CHRISTUS PHCS
CHRISTUS ST PATRICK HOSPITAL (SELF-INSURED)
CHRYSLER LIFE INS. CO.
CHUBB LIFE AMERICA
CHURCH MUTUAL INSURANCE CO
3180-00
1130-00
0885-00
3482-00
0949-00
2708-00
0895-00
4103-00
3255-00
3598-00
3060-00
0097-00
1578-00
3209-00
5 GATEWAY CENTER/STE 620
60 BLVD. OF THE ALLIES
P O BOX 51118
P O BOX 23468
P O BOX 9201
P O BOX 2968
BENEFITS ADM MED CLAIMS
KNIGHTSBRIDGE
2175 N GLENVILLE RD
P O BOX 7927
P O BOX 469064
500 LENA DR
P O BOX 359
149 TEATS ST
P O BOX 52115
POST OFFICE BOX 4020
8301 MARYLAND AVENUE
P O BOX 509508
P O BOX 18108
P O BOX 159
1122 GRAY HIGHWAY
POST OFFICE BOX 297
P O BOX 1884
2627 LINWOOD AVE
SOCIETY OF THE DIVINE WOR
201 RUELLA AVE
200 HENRY CLAY
P O BOX 39
P O BOX 23018
P O BOX 70100
395 N SERVICE RD
P O BOX 14586
P O BOX 3559
111 VETERANS MEM BLVD
STE 425
4527 NORTH 16TH STREET
SUITE 102
P O BOX 691
P O BOX 681
1205 WINDHAM PARKWAY
P O BOX 674
316 DALLAS HWY
2700 NAPOLEON AVENUE
P O BOX 336
P O BOX 660044
P O BOX 250089
P O BOX 1339
P O BOX 1393
900 TOWER DRIVE
P O BOX 551
P O BOX 342
EXTON
BEDFORD
ROMEOVILLE
STERLING
WAXAHACHIE
NEW ORLEANS
MONTEZUMA
DALLAS
PLANO
MINNEAPOLIS
LAKE CHARLES
TROY
CHATTANOOGA
MERRILL
PA
TX
IL
IL
TX
LA
KS
TX
TX
MN
LA
MI
TN
WI
19341
76021
60446
61081
75165
70115
67867
75266
75025
55440
70602
48098
37401
54452
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
21
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
CHURCH OF GOD IN CHRIST INC
1895-00
NORFOLK
VA
23502
CHURCH POINT INDUSTRIES
CIBA-GEIGY CORP
CIERRA HEALTH & LIFE
CIGNA
2218-00
2187-00
3216-00
3349-00
CHURCH POINT
ST. GABRIEL
LATHAM
SOUTHFIELD
LA
LA
NY
MI
70525
70776
12110
48034
CIGNA
CIGNA
CIGNA
CIGNA
CIGNA
CIGNA
CIGNA
CIGNA
CIGNA
CIGNA
CIGNA
CIGNA
CIGNA
CIGNA
CIGNA
CIGNA
CIGNA
CIGNA
CIGNA
CIGNA
CIGNA (BOILERMAKERS)
CIGNA BEHAVIORAL
CIGNA BEHAVIORAL HEALTH
CIGNA CORPORATE HEADQUARTERS
CIGNA DENTAL
CIGNA GOVERNMENT SERVICES
CIGNA INTERNATIONAL EXPARTIATE BEN
CIGNA MEDICARE ACCESS PLUS
CIGNA VOLUNTARY
CINERGY HEALTH
CIRCLE K CORPORATION
3348-00
3347-00
3346-00
3344-00
3343-00
3342-00
3462-00
3459-00
3510-00
3642-00
1740-00
1261-00
H276-20
4052-00
4049-00
4015-00
3886-00
0871-00
1083-00
0708-00
3721-00
3415-00
3389-00
4000-00
3803-00
3576-00
3677-00
H035-40
3904-00
3589-00
2329-00
WILMINGTON
PLAINVILLE
COLUMBUS
ATLANTA
COLUMBUS
CHARLOTTE
SCRANTON
SCRANTON
VISALIA
PHOENIX
CHATTANOOGA
BRISTOL
CHATTANOOGA
CHATTANOOGA
CHATTANOOGA
CHATTANOOGA
KENNETT
SHERMAN
BOURBONNAIS
CHATTANOOGA
SCRANTON
EDENPRAIRIE
EDEN PRAIRIE
BLOOMFIELD
PLANTATION
NASHVILLE
WILMINGTON
SAN ANTONIO
PHOENIX
LAKE HIAWATHA
SHREVEPORT
DE
CT
OH
GA
OH
NC
PA
PA
CA
AZ
TN
CT
TN
TN
TN
TN
MO
TX
IL
TN
PA
MN
MN
CT
FL
TN
DE
TX
AZ
NJ
LA
19850
06062
43218
30359
43216
28233
18505
18505
93278
85078
37422
06010
37422
37422
37422
37422
63857
75091
60914
37422
18505
55344
55344
06002
33318
37202
19850
78269
85051
07034
71104
CITADEL LIFE INS. CO., THE
CITGO PETROLEUM GROUP HEALTH CARE
CITIZENS FIDELITY INSURANCE COMPANY
CITIZENS INS. CO. OF AMERICA
CITIZENS SECURITY LIFE INS. CO.
CITY HEALTH PLAN
0098-00
1116-00
0956-00
0099-00
2231-00
3059-00
CHARLOTTE
TULSA
LITTLE ROCK
AUSTIN
LOUISVILLE
SAN FRANCISCO
NC
OK
AR
TX
KY
CA
28231
74101
72202
78714
40253
94103
CITY OF ALEXANDRIA BENEFIT CONTROL SERVICES
CITY OF AUSTIN
1702-00
2354-00
DENHAM SPRINGS
AUSTIN
LA
TX
70727
78750
CITY OF BATON ROUGE
CITY OF BOSSIER CIYT MEDICAL BENEFIT PLAN
2072-00
1441-00
HOSPITAL FUND
5739 SELLGER DR
P O DRAWER A
P O BOX 11
P O BOX 730
26913 NORTHWESTERN HWY
SUITE 300
P O BOX 15408
P O BOX 8012
P O BOX 182331
P O BOX 29000
P O BOX 16672
P O BOX 33638
P O BOX 5300
P O BOX 3598
P O BOX 5026
P O BOX 55270
P O BOX 18223
32 VALLEY ST
P O BOX 182223
P O BOX 188050
P O BOX 188004
P O BOX 188061
1000 GREAT WEST DR
P O BOX 2546
P O BOX 2100
PO BOX 182223
P O BOX 5909
P O BOX 46270
P O BOX 46270
900 COTTAGE GROVE RD
P O BOX 189060
P O BOX 20010
P O BOX 15050
P O BOX 696018
P O BOX 55270
144 N BEVERWYCK
US DENTAL INSURANCE
3645 SOUTHERN AVE
POST OFFICE BOX 31488
P O BOX 3648
901 MARSHALL
POST OFFICE BOX 149151
P O BOX 436149
1145 MARKET STREET
2ND FLOOR
P O BOX 758
12325 HY MEADOW DR
BLDG 4
P O BOX 80666
P O BOX 5756
BATON ROUGE
SHREVEPORT
LA
LA
70898
71135
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
22
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
CITY
CITY
CITY
CITY
CITY
CITY
CITY
1175-00
0720-00
1883-00
0747-00
2327-00
1445-00
2848-00
P O BOX 15230
201 N ECTOR DR
511 N CUSHING
P O BOX 4017C
P O BOX 900
P O BOX 698
1360 PEACHTREE ST N.E.
SUITE 325
PO BOX 12830
P O BOX 37
1300 PERDIDO ST
P O BOX 5756
P O BOX 379
P O BOX 140067
P O BOX 3968
SUITE 402
1575 SAN IGNACIO
P O BOX 10888
2240 EAST PRIEN LAKE ROAD
HEALTH BENEFITS PLAN
P O BOX 1837
P O BOX 1459
P O BOX 5000
P O BOX 51005
7124 WINDSOR LAKE PARKWAY
P O BOX 11549
P O BOX 8002
P O BOX 76149
OFF.OF WORKERS COMP.PROG.
ROOM C-3316
P O BOX 101387
P O BOX 2175
POST OFFICE BOX 56189
P O BOX 720460
P O BOX 870789
11925 ENTERPRISE PKWY
POST OFFICE BOX 68181
1200 COLONIAL LIFE BLVD
POST OFFICE BOX 216
HEALTH CLAIMS DEPT 1250
COLONIAL PENN PLAZA
129 S FIFTH ST
P O BOX 3360
P O BOX 17470
P O BOX 683
RD 5
P O BOX 2180
88 E. BROAD STREET
STE. 1800
COLUMBIA PLAZA, BOX 30
P O BOX 771989
DALLAS
EULESS
KAPLAN
LAFAYETTE
LAKE CHARLES
MARSHALL
ATLANTA
TX
TX
LA
LA
LA
TX
GA
75201
76039
70548
70502
70602
75671
30309
JACKSON
NATCHITOCHES
NEW ORLEANS
SHREVEPORT
ST MARTINVILLE
KANSAS CITY
BOCA RATON
CORAL GABLES
MS
LA
LA
LA
LA
MO
FL
FL
39236
71457
70112
71135
70582
64114
33427
33146
GREENBAY
LAKE CHARLES
LAS VEGAS
WI
LA
NV
54307
70601
89125
BILOXI
PINEVILLE
SHREVEPORT
ROCKFORD
TUCSON
LITTLE ROCK
COLORADO SPRINGS
WASHINGTON
MS
LA
LA
IL
AZ
AR
CO
DC
39533
71361
71135
61111
85734
72203
80970
20210
FORT WORTH
MONROE
ATLANTA
OKLAHOMA CITY
STONE MOUNTAIN
TWINSBURG
INDIANAPOLIS
COLUMBIA
PARSIPPANY
PHILADELPHIA
TX
LA
GA
OK
GA
OH
IN
SC
NJ
PA
76185
71207
30343
73172
30087
44087
46268
29202
07054
19181
GRAMERCY
LA
70052
DENVER
HOUSTON
BLOOMSBURG
LOUISVILLE
COLUMBUS
CO
TX
PA
KY
OH
80217
77001
17815
40201
43215
GREENSBURG
HOUSTON
PA
TX
15601
77215
OF
OF
OF
OF
OF
OF
OF
DALLAS HEALTH BENEFIT PLAN
EULESS EMPLOYEE BENEFIT PLAN
KAPLAN EMPLOYEE BENEFIT TRUST
LAFAYETTE
LAKE CHARLES
MARSHALL, TEXAS (SELF-EMPLOYED)
MEMPHIS-TN PRIMARY CARE NETWORK
CITY OF MONROE INSURANCE SYSTEMS
CITY OF NATCHITOCHES
CITY OF NEW ORLEANS GROUP PLAN
CITY OF SHREVEPORT HEALTH CARE PLAN
CITY OF ST MARTINVILLE
CLAIMEDIX, INC
CLAIMS ADMINISTRATION SERVICES INC
CLAIMS DEVELOPMENT CORP-ROTOCAST PLASTIC PRODUCTS INC
0873-00
1357-00
0771-00
1177-00
2037-00
4018-00
1986-00
1662-00
CLAIMS MANAGEMENT SERVICES INC
CLARK COLLEGE
CLARK COUNTY NEVADA & AFFILIATES SELF FUNDED
2460-00
2047-00
2937-00
CLASSIC HEALTH
CLECO (CENTRAL LA. ELECTRIC CO.)
CLEMENT INDUSTRIES INC
CLINICARE
CMC STEEL GROUP-WEST
CNA INSURANCE CO/HEALTHSCOPE BENEFITS
CNIC HEALTH SOLUTIONS
COAL MINE WORKERS COMP-DEPT OF LABOR
1621-00
1512-00
2324-00
1847-00
3172-00
0817-00
3296-00
1704-00
COALITION AMERICA
COASTAL DRILLING LAND
COASTAL STATES LIFE INS. CO.
COATES FIELD SERVICE INC
COBRA ADMINISTRATIVE SERVICES
COLE MANAGED VISION
COLLEGE LIFE INS. CO. OF AMERICA, THE
COLONIAL LIFE & ACCIDENT
COLONIAL LIFE INS. CO. OF AMERICA, THE
COLONIAL PENN LIFE INS. CO.
2946-00
3423-00
0100-00
3290-00
2664-00
3130-00
0101-00
0102-00
0103-00
0104-00
COLONIAL SUGARS INC MEDICAL PLAN
1683-00
COLORADO
COLUMBIA
COLUMBIA
COLUMBIA
COLUMBIA
H062-10
2060-00
1971-00
2669-00
0105-00
ACCESS
GAS SYSTEMS
LIFE INSURANCE CO
MEDICAL PLAN
NATIONAL LIFE INS. CO.
COLUMBIA PHARMACY SOLUTIONS
COLUMBIA UNIVERSAL LIFE INSURANCE
2792-00
1128-00
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
23
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
COLUMBIAN MUTUAL LIFE INS. CO.
COLUMBUS MUTUAL LIFE INS. CO., THE
COMBINED AMERICAN LIFE
COMBINED INS. CO. OF AMERICA
COMBINED INSURANCE
COMBINED UNDERWRITERS LIFE INS. CO.
COMCAR INDUSTRIES (SELF-INSURED)
COMET INDUSTRIES INC
COMMERCE BENEFITS PLANS INC
0106-00
0107-00
0773-00
0108-00
3754-00
0109-00
2568-00
2223-00
3034-00
BINGHAMTON
COLUMBUS
LONGHORNE
CHICAGO
BELLINGHAM
TYLER
AUBURNDALE
KANSAS CITY
ELYRIA
NY
OH
PA
IL
WA
TX
FL
MO
OH
13902
43216
19047
60640
98227
75710
33823
64120
44036
COMMERCIAL LIFE INS. CO.
COMMERCIAL NATIONAL BANK
0110-00
1503-00
CHICAGO
SHREVEPORT
IL
LA
60606
71101
COMMERCIAL TRAVELERS
COMMERCIAL UNION LIFE INS. CO. OF AMERICA
COMMONWEALTH LIFE AND ACCIDENT INS. CO.
3906-00
0111-00
0112-00
UTIC
BOSTON
ST. LOUIS
NY
MA
MO
13502
02108
63156
COMMONWEALTH LIFE INS CO
COMMONWEALTH LIFE INS. CO.
3709-00
0113-00
ANDOVER
LOUISVILLE
MA
KY
01810
40202
COMMONWEALTH NATIONAL LIFE INS. CO.
COMMUNICATION CORP
COMMUNITY AMBULANCE SERVICE
COMMUNITY CARE NETWORK
COMMUNITY HEALTH ALLIANCE SUMMIT INS
0114-00
3106-00
1614-00
2284-00
1397-00
CLEVELAND
LAFAYETTE
CULLEN
METAIRIE
BREAUX BRIDGE
MS
LA
LA
LA
LA
38732
70506
71021
70010
70517
COMMUNITY HEALTH SYSTEM INC
COMMUNITY HEALTH/UNITED HCA
COMMUNITY MUTUAL INSURANCE CO
2907-00
1193-00
1237-00
BRENTWOOD
DALLAS
CINCINNATI
TN
TX
OH
37027
75266
45206
COMMUNITYCARE OF OKLAHOMA
COMP MED-CITY OF OKLAHOMA CITY
COMP SYCH CORPORATION
COMPANION LIFE INS. CO.
COMPASS ROSE BENEFITS
COMPLETE BENEFIT SOLUTIONS
COMPLETE HEALTH
COMPREHENSIVE BENEFIT ADMINISTRATOR INC
3844-00
2141-00
3444-00
2532-00
3977-00
3171-00
2006-00
1326-00
TULSA
TULSA
CHICAGO
COLUMBIA
ANNAPOLIS
DENHAM SPRINGS
BIRMINGHAM
MIAMI
OK
OK
IL
SC
MD
LA
AL
FL
74119
74102
60680
29260
21401
70726
35205
33183
COMPREHENSIVE CARE SERVICES
COMPREHENSIVE CARE SERVICES INC
CON AGRA GROUP INSURANCE
CON CHO (SELF-INSURED)
CON-AIR CORP
CONAGRA MEDICAL INSURANCE PLAN
CONCERT HEALTH PLAN
3275-00
3299-00
1049-00
1772-00
1183-00
0733-00
3219-00
ST PAUL
ST PAUL
NATCHITOCHES
GARLAND
EDISON
JEANERETTE
OAKBROOK
MN
MN
LA
TX
NJ
LA
IL
55164
55164
71458
75042
08816
70544
60523
CONCESSION AIR
CONCORDIA HEALTH PLAN OF THE LUTHERAN CHURCH
CONEXIS
CONFEDERATION ADMINISTRATION SERVICES
2175-00
0745-00
3544-00
1479-00
VESTA PARKWAY EAST
303 EAST BROAD STREET
P O BOX 1009
5050 N BROADWAY
P O BOX 638
POST OFFICE BOX 2503
P O DRAWER 67
4800 DERAMUS
SOUTHEAST ADMINISTRATORS
P O BOX 900
200 SOUTH WACKER DRIVE
SELF-FUNDED PLAN
333 TEXAS STREET
70 GENESEE ST
ONE BEACON STREET
POST OFFICE BOX 8080
COLLEGE STATION
P O BOX 9016
COMMONWEALTH BUILDING
FORTH AND BROADWAY
POST OFFICE BOX 1057
1749 BERTAND DR
P O BOX 317
P O BOX 7070
PLAN/GROUP PROGRAMS INC
P O BOX 1180
155 FRANKLIN RD
P O BOX 660451
AFC SERVICE CEN CK3-485
1351 WILLIAM H TAFT RD
218 W 6TH ST
P O BOX 3028
P O BOX 8379
P O BOX 6000
P O BOX 6430
102 NORTH RANGE
2160 HIGHLAND AVE/STE 100
7990 S W 117TH AVE
SUITE 134
P O BOX 64668
P O BOX 64668
P O BOX 1008
196 INTERNATIONAL
11 EXECUTIVE AVENUE
P O BOX 228
2605 W 22ND ST
STE 25
P O BOX 1860
1333 S KIRKWOOD RD
P O BX 226101
250 SOUTH WACKER DR
INDIANAPOLIS
ST LOUIS
DALLAS
CHICAGO
IN
MO
TX
IL
46706
63122
75222
60606
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
24
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
CONFEDERATION LIFE INS. CO.
0115-00
ONTARIO
ON
00000
CONFEDERATION LIFE INSURANCE
0115-01
SANTURCE
PR
00910
CONGER LIFE INS. CO.
0116-00
MIAMI
FL
33137
CONGRESS LIFE INC
2779-00
RICHARDSON
TX
75083
CONNECTICARE INC
CONNECTICARE INC
CONNECTICUT CARE
CONNECTICUT CARE
CONNECTICUT GENE
CONNECTICUT GENE
CONNECTICUT GENERAL
CONNECTICUT GENERAL LIFE INS CO
CONNECTICUT GENERAL LIFE INS. CO.
CONNECTICUT GENERAL LIFE INSURANCE COMPANY
CONNECTICUT MUTUAL LIFE INS. CO.
CONNECTICUT NATIONAL LIFE
CONNECTION DENTAL
CONSECO HEALTH INS CO
CONSECO VARIABLE INSURANCE
CONSOCIATE
CONSOCIATE
CONSOLIDATE HEALTH PLANS,INC
CONSOLIDATED ADMINISTRATORS
CONSOLIDATED AMERICAN LIFE INS. CO.
CONSOLIDATED BANKERS LIFE INS. CO. OF LA
CONSOLIDATED BENEFITS HEALTH CARE FUND 6
CONSOLIDATED BENEFITS SERVS C/O CARPENTERS LOCAL
H352-80
H036-00
H059-00
3582-00
1164-00
1155-00
1044-00
3870-00
0506-00
0830-00
0117-00
1285-00
3933-00
2983-00
4010-00
3618-00
3676-00
2713-00
2025-00
0118-00
0119-00
2177-00
1988-00
FARMINGTON
FARMINGTON
FARMINGTON
FARMINGTON
PLAINVILLE
PLAINVILLE
SHERMAN
PHOENIX
SHERMAN
PLAINVILLE
HARTFORD
SHREVEPORT
INDEPENDENCE
CARMEL
CARMEL
DECATUR
DECATUR
METAIRIE
RALEIGH
JACKSON
SHREVEPORT
PHOENIX
ATLANTA
CT
CT
CT
CT
CT
CT
TX
AZ
TX
CT
CT
LA
MO
IN
IN
IL
IL
LA
NC
MS
LA
AZ
GA
06034
06034
06034
06034
06062
06062
75091
85078
75090
06062
06115
71161
64051
46032
46082
62525
62525
70004
27627
39205
71130
85078
30319
CONSOLIDATED EMPLOYEE BENEFITS
2665-00
STONE MOUNTAIN
GA
30087
CONSOLIDATED
CONSOLIDATED
CONSOLIDATED
CONSOLIDATED
CONSOLIDATED
CONSOLIDATED
CONSOLIDATED
CONSOLIDATED
CONSTITUTION
CONSTRUCTION
2040-00
2268-00
2700-00
2712-00
0911-00
2426-00
2720-00
3734-00
0120-00
0530-00
321 BLOOR STREET, EAST
TORONTO 5
P O BOX 11007
FERNANDEZ JUNCOS STATION
POST OFFICE BOX 1068
BUENA VISTA STATION
BLIC ADMINISTORS
P O BOX 836150
P O BOX 4000
P O BOX 4000
P O BOX 546
P O BOX 546
80 SPRING LANE
80 SPRING LANE
P O BOX 2546
P O BOX 55270
POST OFFICE BOX 2546
POST OFFICE BOX 8014
140 GARDEN STREET
P O BOX 1
P O BOX 2336
11825 N PENNSYLVANIA ST
P O BOX 2009
151 E DECATURE ST
151 E DECATURE ST
P O BOX 1878
P O BOX 37429
POST OFFICE BOX 59
POST OFFICE BOX 3999
P O BOX 55237
UNION #225
1400 LAKE HEARN DR #300
2300 WEST PARK PLACE BLVD
SUITE 114
P O BOX 3988
P O BOX 677
P O BOX 432910
P O BOX 1878
3900 THANKSGIVING TOWER
P O BOX 349
810 EMMERTON RD
P O BOX 12549
325 WEST TOUHY AVENUE
LABORERS LOCAL UNION 1177
1233 GOVERNMENT ST.
116 COMMERCE DRIVE
6310 W APPLETON AVE
P O BOX 720
P O BOX 201425
3420 BARANCAS AVE
2100 M STREET, N.W.
PORTLAND
GREENFIELD
S.MIAMI
METAIRIE
DALLAS
TROY
ABINGTON
LAKE CHARLES
PARK RIDGE
BATON ROUGE
OR
MA
FL
LA
TX
AL
MD
LA
IL
LA
97208
01302
33243
70004
75201
36081
21009
70612
60068
70802
JEFFERSON CITY
MILWAUKEE
DELAWARE
ARLINGTON
PENSACOLA
WASHINGTON
MO
WI
OH
TX
FL
DC
65101
53210
43015
76006
32507
20037
FREIGHTWAYS INC HEALTH PLAN
GRAIN
GROUP
HEALTH PLAN
MEDICAL,DISABILITY & LIFE TRUST
NATIONAL LIFE INSURANCE COMPANY
TRANSPORTATION INSURANCE TRUST FUND
WATERWORKS
LIFE INS. CO.
& GENERAL
CONSTRUCTION INDUSTRY LABORERS WELFARE FUND
CONSTRUCTION WORKERS HEALTH FUND
CONSULTANTS & ADMINISTRATORS (SELF-INSURED)
CONSUMER ALLIANCE USA
CONSUMER BENEFIT ASSOCIATION OF THE U.S.
CONSUMERS UNITED INS. CO.
0793-00
1871-00
1884-00
3647-00
1522-00
0121-00
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
25
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
CONTAINER CARE HOUSTON
2870-00
GALENA PARK
TX
77547
CONTINENTAL AMERICAN LIFE INS. CO.
CONTINENTAL ASSURANCE CO.
CONTINENTAL BAKING COMPANY
CONTINENTAL BANKERS LIFE INS. CO. OF THE SOUTH
CONTINENTAL CASUALTY
CONTINENTAL GENERAL INSURANCE COM
CONTINENTAL GENERAL INSURANCE COMPANY
CONTINENTAL LIFE & ACCIDENT CO.
CONTINENTAL LIFE INS CO
CONTINENTAL LIFE INS. CO.
CONTINENTAL LOSS ADJUSTMENT SERVICES INC
CONTINENTAL MEDICAL SYSTEM INC
CONTINENTAL SECURITY LIFE INS. CO.
CONTINENTAL SERVICE LIFE AND HEALTH INS. CO.
CONTINENTAL WESTERN LIFE INS. CO.
CONTINUAL LIFE INSURANCE CO
CONTINUED HEALTH CARE BENEFIT PROGRAM
CONTRACTORS EMPLOYEE BENEFITS ADMIN
0122-00
0123-00
1368-00
0124-00
0756-00
3793-00
0125-00
0126-00
3705-00
0127-00
1789-00
1699-00
0128-00
0129-00
0130-00
1830-00
2688-00
3178-00
NEWARK
CHICAGO
DALLAS
DALLAS
CHICAGO
AUSTIN
OMAHA
BOISE
BRENTWOOD
FORT WORTH
METAIRIE
LANCASTER
JEFFERSON CITY
BATON ROUGE
WEST DES MOINES
SHAWNEO MISSION
ROCKVILLE
AUSTIN
DE
IL
TX
TX
IL
TX
NE
ID
TN
TX
LA
PA
MO
LA
IA
KS
MD
TX
19713
60604
75235
75380
60685
78755
68124
83701
37027
76102
70009
17603
65101
70821
50265
66201
20849
78730
CONTRACTORS EMPLOYEE BENEFITS ADMINISTRATION INC
2994-00
AUSTIN
TX
78758
CONTROL DATA
CONTROL DATA HEALTH CARE SERVICES
CONWOOD COMPANIES
COOOPER-BELDEN CORPORATION SELF-INSURED
COOPER TIRE COMPANY
COOPERATIVE BENEFIT ADMINISTRATOR
COOPERATIVE BENEFIT ADMINISTRATORS
COOPERATIVE HEALTH ASSOCIATES
COORDINATED BENEFIT PLANS
COORDINATED BENEFITS
COORDINATED BENEFITS
CORE HEALTH
CORE PPF
CORE SOURCE
CORESOURCE
CORESTAR
0786-00
1041-00
2908-00
1989-00
0804-00
2760-00
3813-00
1137-00
3965-00
3898-00
3851-00
3872-00
3903-00
2462-00
3465-00
3021-00
OKLAHOMA CITY
RICHARDSON
MEMPHIS
JENA
TEXARKANA
LINCOLN
LINCOLN
KANSAS CITY
EAGAN
TAMPA
TAMPA
LUBBOCK
BIRMINGHAM
MATTESON
CLINTON
BROOKLYN CENTER
OK
TX
TN
LA
AR
NE
NE
MO
MN
FL
FL
TX
AL
IL
IA
MN
73125
75083
38101
71342
75502
68506
68506
64116
55121
33623
33622
79490
35298
60443
52733
55430
CORPORATE BENEFIT SOLUTIONS INC
CORPORATE BENEFITS SERVICE INC
3078-00
2387-00
LITTLE ROCK
CHARLOTTE
AR
NC
72221
28202
CORPORATE CARE
CORPORATE CLAIMS SERVICE INC
0872-00
2384-00
WORCHESTER
CHARLOTTE
MA
NC
01613
28202
CORPORATE DIVERSIFIED SERVICE INC.
2420-00
OMAHA
NE
68124
CORPORATE GROUP BENEFITS
CORPORATE HEALTH ADMINISTRATORS
2239-00
2820-00
500 MAYO SHELL
P O BOX 72
300 CONTINENTAL DRIVE
310 SOUTH MICHIGAN AVENUE
9000 DENTON DRIVE
P.O. BOX 809008
CNA PLAZA
P O BOX 30010
P O BOX 247007
POST OFFICE BOX 1599
101 CONTINENTAL PLACE
CONTINENTAL LIFE BUILDING
P O BOX 5904
P O BOX 1523
POST OFFICE BOX 242
POST OFFICE BOX 3397
POST OFFICE BOX 65770
P O BOX 470
P O BOX 1608
6300 BRIDGEPOINT PARKWAY
BUILDING 3, SUITE 500
9003 WATERFORD CENTRE
BLVD., SUITE 100
KERR MAGEE CTR
PO BOX 833823 DEPT 199
P O BOX 217
P O BOX 1180
RT 12 BOX 252
P O BOX 6249
P O BOX 6249
P O BOX 7305
P O BOX 21517
P O BOX 26222
P O BOX 20594
P O BOX 15953
P O BOX 995
P O BOX 168
P O BOX 2920
6200 SHINGLE CREEK PKWY
SUITE 665
P O BOX 8215
139 S TRYON ST
6TH FLOOR
PO BOX 1075
139 S TRYON ST
SUITE 607
2120 SOUTH 727 ST
SUITE 400
P O BOX 2908
MARQUIS PLAZA/STE 300
5313 CAMPBELLS RN RD
LIVONIA
PITTSBURG
MI
PA
48151
15203
LAM1R032
RUN: 09/24/16 07:28:56
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DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
26
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
CORPORATE SERVICE INC
CORRECTCARE INTEGRATED HEALTH
CORROON & BLACK BENEFITS INC
CORVEL
1985-00
4134-00
1259-00
3194-00
BENTONVILLE
NASHVILLE
NASHVILLE
METAIRIE
AR
TN
TN
LA
72712
37217
37202
70001
COST CARE
COST MANAGEMENT TECHNOLOGIES INC
2517-00
2576-00
HUNTINGTON BEACH
KANSAS CITY
CA
MO
92647
64111
COSTCO MEDICAL PLAN
COTTER MEMBER INSURANCE (W/JOHN HANCOCK)
COTTON BROTHERS BAKERY
COUNTRY COMPANIES INSURANCE & INVESTMENT SERVICES
COUNTRYMARK COOPERATIVE INC
COUSHATTA INSURANCE PLAN
COVENANT ADMINISTRATION
COVENANT ADMINISTRATORS
COVENANT ADMINISTRATORS, INC.
2772-00
1148-00
0893-00
1086-00
2753-00
2973-00
2808-00
3532-00
3608-00
LITTLE ROCK
CARY
ALEXANDRIA
BLOOMINGTON
DUBLIN
ELTON
ATLANTA
ATLANTA
LAWRENCEVILLE
AR
IL
LA
IL
OH
LA
GA
GA
GA
72203
60013
71301
61702
43017
70532
30374
30348
30043
COVENTRY HEALTH CARE
COVENTRY HEALTH CARE KS
COVENTRY HEALTH CARE NATIONAL NETWK
COVENTRY HEALTHCARE OF LA
COVENTRY--MEDICARE ADVANTAGE
COX HEALTH SYSTEMS HMO INC
CR-PL BENEFIT PLAN
CRACKER BARREL STORES INC (SELF-INSURED)
CRAIN BROTHERS INC
CRAWFORD & COMPANY
CREATIVE PLANNING
CREDIT LIFE INS. CO., THE
CRESCENT DENTAL PLANS
CRESCENT SOLUTION
CREST INDUSTRIES (SELF-EMPLOYED)
CROSSAMERICA HEALTH PLANS
CROWN CORK & SEAL COMPANY
CROWN LIFE INS. CO.
CRUM AND FORSTER
CST GROUP INC
CSX BENEFITS
3001-00
3412-00
3535-00
3517-00
H392-80
3133-00
1229-00
1487-00
1872-00
1036-00
1537-00
0131-00
3162-00
4082-00
1507-00
3504-00
2663-00
0132-00
1926-00
1739-00
2008-00
LONDON
LONDON
LONDON
METAIRIE
LONDON
SPRINGFIELD
DALLAS
SHREVEPORT
GRAND CHENIER
HOUMA
DUBIN
SPRINGFIELD
PHOENIX
ALPHARETTA
ALEXANDRIA
PARSIPPANY
PHILADELPHIA
TORONTO
DALLAS
ARLINGTON
JACKSONVILLE
KY
KY
KY
LA
KY
MO
TX
LA
LA
LA
OH
OH
AZ
GA
LA
NJ
PA
ON
TX
IL
FL
40742
40742
40742
70002
40742
65801
75239
71135
70643
70301
43017
45501
85046
30039
71301
07054
19136
00000
75252
68006
32231
CTI ADMINISTRATORS
CUDIS INS. SOCIETY, INC.
CULINARY WORK HEALTH FUND
CUMBERLAND LIFE INS. CO.
CUNA MUTUAL INS. SOCIETY
CVS CAREMARK
2951-00
0133-00
3122-00
0134-00
0135-00
3846-00
DES MOINES
MADISON
LOS VEGAS
DALLAS
MADISON
IA
WI
NV
TX
WI
AZ
50309
53701
89104
75266
53701
85072
CWI BENEFITS/MANAGEMED
CYANAMID PERSONAL PROTECTION PROGRAM
D & B PLAN SERVICES INC
D & J CONSTRUCTION CO., INC (SELF-INSURED)
3675-00
0719-00
2317-00
2068-00
P O BOX 1288
1283 MURFREESBORO RD, SUI
P O BOX 1140
1 GALLERIA BLVD
STE 1775
17011 BEACH BOULEVARD
4435 MAIN
SUITE 810
P O BOX 8049
203 JARDUS RD
3400 MCARTHUR DRIVE
P O BOX 2000
P O BOX 9059
P O BOX 1029
P O BOX 740042
P O BOX 105738
1745 N BROWN RD
SUITE 400
P O BOX 7707
P O BOX 7087
P O BOX 8400
3838 N CAUSEWAY BLVD
P O BOX 7819
P O BOX 5750
8290 SOUTH CENTRAL
P O BOX 51005
P O BOX 1186
P O BOX 1086
4430 TULLER RD
100 S. LIMESTONE STREET
P O BOX 30730
P O BOX 247
P O BOX 1432
P O BOX 5778
9300 ASHTON ROAD
120 BLOOR STREET
18383 PRESTON RD, STE 500
P O BOX 3011
DEPT J-905
P O BOX 44055
100 COURT AVE/STE 306
POST OFFICE BOX 391
1921 LOS VEGAS BLVD
POST OFFICE BOX 660028
POST OFFICE BOX 391
P O BOX 52115
PHOENIX
P O BOX 17264
P O BOX 2068
P O BOX 30753
P O BOX 51005
GREENVILLE
CLIFTON
TAMPA
SHREVEPORT
SC
NJ
FL
LA
29606
07015
33630
71135
LAM1R032
RUN: 09/24/16 07:28:56
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DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
27
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
D M B A
2332-00
SALT LAKE CITY
UT
84145
D.W.G. INSURANCE AND RISK MANAGEMENT
DAKOTACARE
DALLAS FT.WORTH ROOFERS & WATERPRO0FERS
1318-00
3235-00
2833-00
MIAMI BEACH
SIOUX FALLS
PLANO
FL
SD
TX
33141
57105
75086
DALLAS GENERAL LIFE INS CO
DALLAS NATIONAL
DALLAS NATIONAL LIFE
DANIEL AND HENRY GROUP ADMINISTRATIVE TRUST
DATA RX MANAGEMENT
DAVEY TREE INS CO
DAVIS ELECTRICAL CONSTRUCTION (SELF-INSURED)
DAVIS GARVIN AGENCY
DAVIS VISION
DAVISON TRANSPORT
DAYBROOK FISHERIES INC (SELF-INSURED)
DBL SERVICES,INC
DEAN HEALTH PLAN
DEARBORN NATIONAL
DEATON INC.(SELF-EMPLOYED)
DEEP SOUTH EQUIPMENT CO.
DEFINITY
DEFINITY
DEFINITY HEALTH
1920-00
2680-00
1709-00
1636-00
4122-00
1588-00
1501-00
2247-00
4098-00
1105-00
1848-00
1220-00
3327-00
3815-00
1304-00
1919-00
3382-00
3703-00
3146-00
DALLAS
DALLAS
DALLAS
ST LOUIS
CUMMING
KENT
GREENVILLE
COLUMBUS
SAN ANTONIO
RUSTON
EMPIRE
NEW ORLEANS
MADISON
BELLVILLE
BIRMINGHAM
NEW ORLEANS
AMHERST
ATLANTA
ST LOUIS PARK
TX
TX
TX
MO
GA
OH
NC
SC
TX
LA
LA
LA
WI
IL
AL
LA
NY
GA
MN
75221
75380
75380
63103
30040
44240
29602
29221
78205
71270
70050
70176
53705
62223
35201
70129
14226
30374
55416
DEHA
DELAM AMERICAN HEALTH TRUST,THE
DELAWARE AMERICAN LIFE INS. CO.
DELAWARE NATIONAL LIFE INS. CO.
DELCHAMPS HEALTH AND DENTAL BENEFITS
DELHI AMBULANCE ASSOCIATION
DELTA BROKERS
4054-00
0970-00
0547-00
0136-00
1399-00
1631-00
0757-00
INDEPENDENCE
CLEARWATER
WILMINGTON
DOVER
NASHVILLE
DELHI
HARAHAN
MO
FL
DE
DE
TN
LA
LA
64051
33517
19899
19903
37202
71232
70123
DELTA DENTAL
1389-00
LOS ANGELES
CA
90057
DELTA
DELTA
DELTA
DELTA
DELTA
DELTA
DELTA
DELTA
DELTA
DELTA
DELTA
DELTA
DELTA
DELTA
DELTA
4043-00
4037-00
3991-00
3739-00
3694-00
3604-00
3536-00
3795-00
Y795-00
3825-00
3766-00
3787-00
2604-00
3408-00
3712-00
60 E SOUTH TEMPLE
P O BOX 45530
P O BOX 41-4043
1323 S MINNESOTA AVE
HEALTH & WELFARE FUND
P O BOX 860037
P O BOX 1080
P O BOX 809059
P O BOX 809059
100 NORTH JEFFERSON
5920 ODELL ST
1500 N MANTUA ST
P O BOX 1907
P O BOX 21627
175 E HOUSTON ST
PO DRAWER 310
P O BOX 128
P O BOX 2230
P O BOX 56099
P O BOX 23060
P O BOX 938
4201 MICHOOD BLVD
P O BOX 9525
P O BOX 740810
1600 UTICA AVE S
SUITE 900
P O BOX 4665
P O BOX 899
12TH & MARKET ST
POST OFFICE BOX 933
P O BOX 1140
P O BOX 596
5817 CITRUS BLVD
SUITE FTG
3700 WILSHIRE BLVD #830
P O BOX 57186
P O BOX 75983
P O BOX 8690
P O BOX 1809
P O BOX 1809
P O BOX 173803
P O BOX 15965
P O BOX 997330
P O BOX 2870
P O BOX 2870
P O BOX 5402
P O BOX 919
P O BOX 789769
9901 LINN STATION RD
P O BOX 9695
P O BOX 30416
SEATTLE
ST LOUIS
ATLANTA
ALPHARETTA
DENVER
N LITTLE ROCK
SACRAMENTO
BOISE
BOISE
LISLE
ANKENY
WICHITA
LOUISVILLE
BOSTON
LANSING
WA
MO
GA
GA
CO
AR
CA
ID
ID
IL
AK
KS
KY
MA
MI
98175
63126
30023
30023
80217
72231
95899
83701
83701
60532
50021
67278
40223
02114
48909
DENTAL
DENTAL
DENTAL
DENTAL
DENTAL
DENTAL
DENTAL
DENTAL
DENTAL
DENTAL
DENTAL
DENTAL
DENTAL
DENTAL
DENTAL
OF
OF
OF
OF
OF
OF
OF
OF
OF
OF
ARKANSAS
CALIFORNIA
IDAHO
IDAHO
ILLINOIS
IOWA
KANSAS
KENTUCKY
MASSACHUSETTS
MICHIGAN
LAM1R032
RUN: 09/24/16 07:28:56
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DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
28
TPL CARRIER FILE LISTING
CARRIER NAME
DELTA
DELTA
DELTA
DELTA
DELTA
DELTA
DELTA
DENTAL
DENTAL
DENTAL
DENTAL
DENTAL
DENTAL
DENTAL
OF
OF
OF
OF
OF
OF
OF
MINNESOTA
MISSOURI
NORTH CAROLINA
OKLAHOMA
PENNSYLVANIA
TENNESSEE
VIRGINIA
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
3952-00
2903-00
3728-00
3326-00
3735-00
3888-00
3805-00
P O BOX 330
P O BOX 16921
P O BOX 1609
P O BOX 548809
ONE DELTA DRIVE
240 VENTURE CIRCLE
4818 STARKEY ROAD
ROANOKE
P O BOX 828
P O BOX 16450
1515 POYDRAS ST
SUITE 1760
940 E SAHARA AVE
3229 CARONDELET ST
P O DRAWER 3557
1235 MISSION STREET
9901 LINN STATION ROAD
P O BOX 3711
P O BOX 1418
12090 S HARRELLS FERRY RD
#A-B
P O BOX 40017
P O BOX 4065
P O BOX 735
P O BOX 1842
5373 S GREEN ST
4TH FLR
3012 19TH STREET
P O BOX 262269
POST OFFICE BOX 19030
10 SOUTH MAIN
P O BOX 45530
P O BOX 631
P O BOX 128
P O BOX 44309
P O BOX 6480
1400 CANAL BLVD
750 N DIAMOND BAR BLVD
P O BOX 2230
3701 KIRBY DR/STE 1050
IRMC
P O BOX 4705
12946 DAIRY ASHFORD
STE 360
11837 BRICKSOME AVE
SUITE A
P O BOX 70100
3502 S RIVERVIEW DR
P O BOX 10130
2 WEST DIXIE HWY
P O BOX 419
MINNEAPOLIS
ST.LOUIS
MINNEAPOLIS
OKLAHOMA CITY
MECHANICSBURG
NASHVILLE
MN
MO
MN
OK
PA
TN
VA
55440
63105
55440
73154
17055
37228
24018
STEVENS POINT
NORTH LITTLE ROCK
NEW ORLEANS
WI
AR
LA
54481
72231
70157
LAS VEGAS
NEW ORLEANS
BATON ROUGE
SAN FRANCISCO
LOUISVILLE
LAMIRADA
TOMBALL
BATON ROUGE
NV
LA
LA
CA
KY
CA
TX
LA
89104
70115
70821
94103
40223
90637
77377
70816
BATON ROUGE
JACKSONVILLE
DENHAM SPRINGS
MEMPHIS
SALT LAKE CITY
LA
FL
LA
TN
UT
70835
32231
70727
38101
84123
METAIRIE
PLANO
JACKSONVILLE
SALT LAKE CITY
LA
TX
FL
UT
70002
75026
32245
84145
MANSFIELD
HACKBERRY
JACKSONVILLE
HARRISBURG
NEW ORLEANS
DIAMOND BAR
NEW ORLEANS
HOUSTON
MONROE
LA
LA
FL
PA
LA
CA
LA
TX
LA
71052
70645
32231
17112
70112
91765
70176
77098
71211
SUGARLAND
TX
77478
BATON ROUGE
LA
70816
SHREVEPORT
PORT ALLEN
LAKE BUENA VISTA
DAVIA
MARLBOROUGH
LA
LA
FL
FL
CT
71137
70767
32830
33004
06447
DELTA DENTAL OF WISCONSIN
DELTA DENTAL PLAN OF ARKANSAS INC
DELTA HEALTH NETWORK
3490-00
1668-00
0869-00
DELTA INS ADMNISTRATORS INC
DELTA LIFE INS
DELTA NATIONAL LIFE INSURANCE CO
DELTA SERVICE PLANS INS. CO.
DELTA USA
DENNY'S GROUP BENEFITS
DENT-ALL PLAN INC
DENTA CARE
1630-00
1932-00
2648-00
0137-00
2594-00
1124-00
2893-00
1478-00
DENTAL
DENTAL
DENTAL
DENTAL
DENTAL
1633-00
2921-00
2088-00
2587-00
3859-00
INSURANCE ADMINISTRATORS, INC
MAINTENANCE ORGANIZATION
MANAGEMENT
NETWORK OF AMERICA
SELECT
DENTAMAX INC
DENVER HEALTH MEDICAL PLAN
DEPENDABLE LIFE INS. CO.
DESERET HEALTHCARE
2726-00
H560-80
0138-00
1763-00
DESOTO PARISH SCHOOL BOARD EMPLOYEES BENEFITS
DEVALL TOWING & BOAT SERVICE OF HACKBERRY
DEXTER INSURANCE
DH EVANS
DIALYSIS CLINIC INC (SELF-INSURED)
DIAMOND BENEFITS LIFE INSURANCE COMPANY
DIAMOND OFFSHORE DRILLING INC
DIGICON EMPLOYEE BENEFITS PLAN
DIMENSIONAL
1887-00
2699-00
3808-00
3733-00
2830-00
1471-00
2589-00
2803-00
1434-00
DINA DENTAL PLAN
3842-00
DINA, INC (DENTAL INSURANCE ADMINISTRATORS INC)
1426-00
DIRECTIONAL WIRELINE SERVICES
DISCOVERY CHEMICALS (SELF-INSURED)
DISNEY GROUP INSURANCE
DISTRICT 2 MEBA AMO MEDICAL PLAN
DIVERSIFIED GROUP BROKERAGE CORP
2285-00
2623-00
1685-00
2559-00
2366-00
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
29
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
DIVERSIFIED GROUP INS
DIVERSIFIED HEALTH CONCEPT CORP
DIVERSIFIED INDUSTRIAL GROUP HEALTH PLAN
0832-00
1814-00
1781-00
METAIRIE
SCOTTSDALE
PARAMOUNT
LA
AZ
CA
70011
85261
90723
DIVERSIFIED PHARMACEUTICAL SERVICES INC
DIXIE NATIONAL LIFE INS. CO.
DOANE PRODUCTS (SELF-INSURED)
DODSON GROUP INSURANCE
DOLLAR GENERAL STORE INSURANCE PROGRAM
DONLEY & HORAN ASSOC
DONOVAN BENEFITS SYSTEM INC
2579-00
0139-00
2889-00
2900-00
0914-00
1860-00
1642-00
DULUTH
JACKSON
ALEXANDRIA
KANSAS CITY
NASHVILLE
INDIANAPOLIS
HOUSTON
MN
MS
LA
MO
TN
IN
TX
55816
39205
71303
64114
37212
46250
77002
DORTH COOMBS INSURANCE INC
1961-00
WICHITA
KS
67201
DOW CHEMICAL GROUP INSURANCE
DRESSER INDUSTRIES PENSION ASSOCIATES
DUAL-PLUS
1336-00
2818-00
1711-00
PLAQUEMINE
ST.LOUIS
LONGBEACH
LA
MO
CA
70765
63127
90815
DUNN & ASSOCIATES BENEFIT ADMNISTRS
DURHAM LIFE INS. CO.
E B C MID AMERICA
E B P
E B SERVICES, INC
E N S C O
E P BREAUX ELECTRIC / SELF-INSURED
E. B. A. & M CORPORATION
E.A.RICHARD AND ASSOCIATES INS CO.
EAGLE AMERICAN LIFE INS. CO.
EAST BATON ROUGE PARISH SCHOOL BOARD
EAST JEFFERSON GENERAL HOSPITAL HEALTH AND DENTAL
EASTERN BENEFIT SYSTEM INC
EATON BENEFITS PAYMENT OFFICE
EBC GULF STATES
EBMS
EBS
EBS CORPORATION
ECHO HEALTH INC
3837-00
0140-00
2465-00
2257-00
2424-00
2279-00
2408-00
3084-00
1771-00
0141-00
2806-00
3007-00
1203-00
2586-00
1755-00
3731-00
3496-00
1725-00
3129-00
COLUMBUS
RALEIGH
LOUISVILLE
SUITE 203
CHARLOTTE
LITTLE ROCK
NEW IBERIA
WESTLAKE VILLAGE
LAFAYETTE
BATON ROUGE
BATON ROUGE
MARRERO
EAST ORANGE
COLUMBUS
MERIDIAN
BILLINGS
LUBBOCK
SHREVEPORT
WESTLAKE
IN
NC
KY
FL
NC
AR
LA
CA
LA
LA
LA
LA
NJ
OH
MS
MT
TX
LA
OH
47202
27611
40299
32751
28210
72221
70562
91359
70593
70895
70806
70073
07018
43216
39302
59104
79493
71135
44145
ECONOMY FIRE & CASUALTY
EDITORS PRESS HMO
EHD ADMINISTRATORS INC (ENGLE HAMBRIGHT & DAVIES)
EL DORADO CLAIMS SERVICE INC
ELECTRICIAN'S LOCAL 576 HEALTH & WELFARE
ELECTRICIANS LOCAL #861
ELECTRICIANS LOCAL 995 HEALTH & WELFARE PLAN
ELECTRONIC DATA SYSTEMS CORP(SELF-INSURED)
ELECTRONIC HEALTH SERVICES
ELK CORPORATION OF TEXAS
EMBLEM HEALTH
EMERGENCY AMBULANCE SERVICE
EMERSON ELECTRIC EMPLOYEE GROUP
2156-00
1850-00
2066-00
2335-00
2839-00
1403-00
0850-00
1654-00
3232-00
2261-00
4128-00
1363-00
0876-00
PO BOX 8142
P O BOX C-51490
8131 E ROSECRANS AVE
SUITE 200
RT 433 P O BOX 6169052
POST OFFICE BOX 22587
7603 US HWY 71 SOUTH
9201 STATE LINE RD
PO BOX 121228
6330 EAST 75, STE 103
440 LOUISIANA ST
SUITE 2120
P O BOX 2697
300 W DOUGLAS, 8TH FLOOR
P O BOX 150
10795 WATSON RD
911 STUDEBAKER ROAD
SUITE 250
P O BOX 2369
POST OFFICE BOX 27807
1833 PLANTSIDE DR
2500 MAITLAND CENTER PKWY
5950 FAIRVIEW RD/STE 810
P O BOX 8200
P O BOX 11640
P O BOX 5079
P O BOX 30070
POST OFFICE BOX 45390
1050 S FOSTER DR
P O BOX 1100
200 FREEWAY DRIVE
P O BOX 16691
P O BOX 871
P O BOX 21367
P O BOX 94488
P O BOX 51005
24650 CENTER RIDGE ROAD
SUITE 160
1600 MAIN ST
#4 TAFT COURT
P O BOX 3080
P O BOX 55237
P O BOX 5543
1715 COMMON ST
8111 TOM DRIVE
5400 LEGACY DR
P O BOX 9554
P O BOX 500
P O BOX 3736
P O BOX 31109
BEAIRD/POVLAN WEEDEAT.DIV
5020 FLOURNOY-LUCA RD
CROSSETT
ROCKVILLE
LANCASTER
PHOENIX
ALEXANDRIA
LAKE CHARLES
BATON ROUGE
PLANO
SALT LAKE CITY
ENNIS
NEW YORK
SHREVEPORT
SHREVEPORT
AR
MD
PA
AZ
LA
LA
LA
TX
UT
TX
NY
LA
LA
71635
20850
17603
85078
71307
70601
70815
75024
84109
75119
12008
71130
71129
LAM1R032
RUN: 09/24/16 07:28:56
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DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
30
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
EMPHESYS
EMPIRE LIFE INS. CO.
EMPIRE STATE MUTUAL LIFE INS. CO.
EMPLOYED BENEFITS SERVICES
EMPLOYEE BENEFIT ADMINISTRATORS
EMPLOYEE BENEFIT CLAIMS GULF STATES
EMPLOYEE BENEFIT CLAIMS OF OHIO INC.
EMPLOYEE BENEFIT CONSULTANTS INC
EMPLOYEE BENEFIT MANAGEMENT COOPERATION
EMPLOYEE BENEFIT MANAGMENT
EMPLOYEE BENEFIT PLAN ADMINISTRATION INC
EMPLOYEE BENEFIT PLAN ASSOCIATION
EMPLOYEE BENEFIT PLAN INC
EMPLOYEE BENEFIT PLANS OF THE SOUTH
EMPLOYEE BENEFIT PROGRAM ACCOUNT
EMPLOYEE BENEFIT SERVICES OF NC
2629-00
0142-00
0143-00
2398-00
2111-00
1387-00
1880-00
3947-00
1106-00
4051-00
2039-00
3994-00
1966-00
0775-00
1256-00
2356-00
MADISON
OMAHA
JAMESTOWN
SHREVEPORT
GRAND RAPIDS
MERIDIAN
CLEVELAND
BROADVIEW HEIGHTS
CROWLEY
BILLINGS
HAMPTON
EXETER
MINNIAPOLIS
NEW ORLEANS
TULSA
CHARLOTTE
WI
NE
NY
LA
MI
MS
OH
OH
LA
MT
NH
NH
MN
LA
OK
NC
53705
68144
14071
71137
49516
39302
44128
44147
70526
59104
03842
03833
55426
70119
74101
28210
EMPLOYEE BENEFIT SOLUTION
3291-00
HOUSTON
TX
77056
EMPLOYEE
EMPLOYEE
EMPLOYEE
EMPLOYEE
EMPLOYEE
EMPLOYEE
2057-00
3959-00
3956-00
2357-00
3972-00
1181-00
P O BOX 5620
2424 SOUTH 130TH CIRCLE
315 NORTH MAIN STREET
P O BOX 70100
P O BOX 6488
P O BOX 871
26600 EMERY INDUSTIAL PKY
3301 E ROYAL ROAD
1125 CAPITOL RD
P O BOX 361400
P O BOX 5090
P O BOX 2000
P O BOX 26340
2475 CANAL STREET SU 110
P O BOX 659
5950 FAIRVIEW RD
SUITE 810
2700 POST OAK BLVD
FLOOR 25
P O BOX 16707
215 STANFORD PKWY
P O BOX 928
P O BOX 70100
P O BOX 13749
7100 NO. BROADWAY
SUITE 4
P O BOX 25980
P O BOX 2523
P O BOX 7683
P O BOX 1370
P O BOX 98044
P O BOX 1625
BOX 5606
COMP (E B A & M)
P O BOX 2457
4789 RING
1100 EMPLOYEES BLVD
1457 GRAND AVENUE
P O BOX 321127
30000 AURORA RD
P O BOX 9137
P O BOX 22867
P O BOX 360
P O BOX 19776
5050 SPRING VALLEY RD
CLAIMS DEPT
2000 WESTWOOD DRIVE
POST OFFICE BOX 712
700 CENTRAL PKWY
BENEFITS DEPARTMENT
P O BOX 6200
JACKSON
FINDLAY
FINDLAY
SHREVEPORT
JACKSON
DENVER
MS
OH
OH
LA
MS
CO
39236
45840
45839
71137
39236
80221
OVERLAND PARK
SPOKANE
STOCKTON
PISCATAWAY
BATON ROUGE
TOPEKA
SHREVEPORT
WEST HELENA
KS
WA
CA
NJ
LA
KS
LA
AR
66225
99220
95207
08855
70898
66601
71335
72390
DUBLIN
GREEN BAY
ST. PAUL
DETROIT
SOLON
FORT WORTH
JACKSON
BELTON
HOUSTON
DALLAS
GREEN BAY
WAUSAU
DES MOINES
STUART
SPRINGFIELD
OH
WI
MN
MI
OH
TX
MS
TX
TX
TX
WI
WI
IA
FL
OH
43017
54344
55105
48232
44139
76147
39215
76513
77224
75244
54344
54401
50503
34994
45501
BENEFIT TRUST
BENEFITS CONSULTANTS
BENEFITS CONSULTANTS
BENEFITS SERVICE
BENEFITS SERVICES
BONOFIT SPECIALISTS
EMPLOYEE HEALTH CARE TRUST
EMPLOYEE PAINTERS' TRUST HEALTH
EMPLOYEE PLAN SERVICES
EMPLOYEE SECURITY PROGRAM
EMPLOYEE'S CHOICE DENTAL
EMPLOYEES BENEFIT ASSOCIATION
EMPLOYEES BENEFIT SERVICE
EMPLOYEES BENEFITS ADMINISTRATION & MANAGEMENT
2667-00
3452-00
1206-00
2488-00
3409-00
1904-00
1103-00
1628-00
EMPLOYEES BENEFITS MANAGEMENT CO-OP
EMPLOYEES HEALTH INSURANCE
EMPLOYEES MUTUAL BENEFIT ASSN. OF ST. PAUL
EMPLOYEES NATIONAL BENEFIT PLAN
EMPLOYEES OF AGENCY RENT A CAR HOSPITALIZATION
EMPLOYEES RESOURCE NETWORK
EMPLOYER BENEFITS ADMINISTRATOR INC
EMPLOYER HEALTH OPTIONS
EMPLOYER PLAN SERVICES INC
EMPLOYERS DIRECT HEALTH
EMPLOYERS HEALTH INSURANCE
EMPLOYERS LIFE INS. CO. OF WAUSAU
EMPLOYERS MODERN LIFE CO.
EMPLOYERS MUTUAL INC
EMRO MARKETING COMPANY
1156-00
1088-00
0144-00
1943-00
2429-00
3119-00
2075-00
3659-00
1900-00
3455-00
0717-00
0145-00
0146-00
3310-00
2675-00
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
31
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
EMS ADMINISTRATIVE SERVICES CORP
ENERGY SERVICE CORP INC
2371-00
1472-00
FORT WORTH
HOUSTON
TX
TX
76102
77074
ENERGY VENTURES INC-MALLARD BAY DRILLING
ENSEARCH EMPLOYEE BENEFIT TRUST
ENTERCORP
ENTERPRISE LIFE INS. CO.
2254-00
1228-00
1078-00
0147-00
NEW IBERIA
HOUSTON
SHREVEPORT
IRVING
LA
TX
LA
TX
70562
77210
71120
75062
ENTRUST
ENVISION RX OPTIONS
EPIC HEALTHCARE GROUP
2557-00
3683-00
1558-00
HOUSTON
TWINSBURG
COSTA MESA
TX
OH
CA
77244
44087
92628
EPOCH
EQUICOR
EQUICOR
EQUICOR
EQUICOR
EQUIFAX
2890-00
2302-00
1125-02
1125-01
1125-00
2798-00
1115 W LANCASTER AVE
9494 SOUTHWEST FREEWAY
SUITE 300
P O BOX 13530
P O BOX 4271
P O BOX 21976
4545 FULLER DRIVE
STE. 230
P O BOX 441588
2181 E AURORA RD/STE 201
MEDICAL BENEFIT TRUST DIV
P O BOX 661700
10795 WATSON ROAD
P O BOX 3310 STATION D
P O BOX 529
P O BOX 34337
P O BOX 2005
5001 SPRING VALLEY RD
STE 1000E
P O BOX 16531
P O BOX 2481
INDIVIDUAL HEALTH CENTER
POST OFFICE BOX 2460
1285 AVE OF AMERICAS
604 LOCUST STREET
P O BOX 34337
P O BOX 720460
1320 LAKE STREET
POST OFFICE BOX 2900
P O BOX 1639
4527 N 16TH STREET
SUITE 102
519 DENNIS DRIVE
P O BOX 14288
P O BOX 12488
P O BOX 6702
P O BOX 12184
P O BOX 5001
POST OFFICE BOX 5047
P O BOX 77
P O BOX 31352
P O BOX 659777
P O BOX 5756
2025 RIVERSIDE DR
P.O. BOX 6090
P O BOX 80297
P O BOX 27667
P O BOX 390873
BLO470-SST
P O BOX 805107
P O BOX 14713
ST.LOUIS
ALBUQUERQUE
COLORADO SPRINGS
CHARLOTTE
FARMINGTON
DALLAS
MO
NM
CO
NC
CT
TX
63127
87190
80901
28226
06034
75224
COLUMBUS
NEW YORK
OH
NY
43216
10116
SALT LAKE CITY
NEW YORK
DES MOINES
CHARLOTTE
OKLAHOMA CITY
FORTH WORTH
LITTLE ROCK
JACKSON
PHOENIX
UT
NY
IA
NC
OK
TX
AR
MS
AZ
84110
10019
50306
28234
73172
76102
72203
39205
85016
CARLYSS
SAINT LOUIS
ST LOUIS
COLUMBIA
CHARLOTTE
PAMPA
WICHITA FALLS
BEEBE PLAIN
SALT LAKE CITY
SAN ANTONIO
SHREVEPORT
COLUMBUS
INGLEWOOD
BATON ROUGE
ST.LOUIS
BLOOMINGTON
LA
MO
MO
SC
NC
TX
TX
VT
UT
TX
LA
OH
CA
LA
MO
MN
70663
63132
63132
29260
28220
79065
76308
05823
84131
78265
71135
43221
90312
70898
63146
55439
CHICAGO
LEXINGTON
IL
KY
60680
40512
CIGNA
EQUITABLE
EQUITABLE H.C.A.CORPORATION
EQUITABLE HCA CORP
HEALTH CARE
EQUITABLE FINANCIAL CORP
EQUITABLE GROUP HEALTH
1391-00
1108-00
EQUITABLE LIFE & CASUALTY INS. CO.
EQUITABLE LIFE ASSUR. SOCIETY OF THE U.S., THE
EQUITABLE LIFE INS. CO. IF IA
EQUITABLE LIFE INSURANCE
EQUITABLE PLAN SERVICE
EQUITIES INTERNATIONAL LIFE INS. CO.
EQUITY NATIONAL LIFE INS. CO.
ERGON INC'S
ERISA ADMINISTRATIVE SERVICES
0149-00
0148-00
0150-00
1091-00
0034-46
0151-00
0152-00
1498-00
2814-00
ESCANDELL ASSOCIATES GROUP HEALTH
ESSENCE
ESSENCE
ESSENTIAL STAFFCARE
ETHIX NATIONAL (A HEALTHCARE CORPORATION)
ETNA
EUREKA LIFE INS. CO. OF AMERICA
EUROPEAN BENEFIT ADMINISTRATORS
EVERCARE CHOICE
EVERCARE CHOICE OF TEXAS
EVERGREEN EMPLOYEE BENEFIT SERVICES
EXECUTIVE & EMPLOYEE BENEFIT PLANS
EXECUTIVE LIFE INS. CO.
EXECUTIVE RISK CONSULTANTS INC
EXPRESS SCRIPT
EXPRESS SCRIPT
2185-00
H261-00
4031-00
3518-00
2555-00
0758-00
0153-00
3777-00
3575-00
H451-40
0969-00
0909-00
0154-00
1407-00
2133-00
3897-00
EXPRESS SCRIPTS
EXPRESS SCRIPTS
4016-00
4060-00
LAM1R032
RUN: 09/24/16 07:28:56
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DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
32
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
EXPRESS SCRIPTS
EXXON MEDICARE SUPPLEMENT
EYE CARE PLAN OF AMERICA
F.A. RICHARD & ASSOCIATES INC
FALCON CLAIMS SERVICE, INC.
4017-00
0711-00
3279-00
2844-00
2477-00
CHICAGO
HOUSTON
MASON
METAIRIE
NEW ORLEANS
IL
TX
OH
LA
LA
60680
77032
45040
70011
70130
FALLON
FAMILY
FAMILY
FAMILY
FAMILY
FAMILY
FAMILY
3391-00
2524-00
1876-00
3280-00
0155-00
3915-00
3113-00
P O BOX 805107
15710 J.F.K. BLVD #500
P O BOX 8504
P O BOX 8770
SUITE 1825
601 POYDRAS ST
P O BOX 15121
P O BOX 1017
P O BOX 3697
P O BOX 470608
POST OFFICE BOX 12620
P O BOX 925568
5745 ESSEN LANE
SUITE 100
P O BOX 8770
334 NORTH TOPEKA
POST OFFICE BOX 16170
P O DRAWER 1796
P O BOX 343
P O BOX 578
P O BOX 7305, DEPT 39
1525 MERRILL DR
400 SOUTH WEST AVENUE
4615 WALZEM ROAD, STE 300
P O BOX 10112
P O BOX 791405
P O BOX 10304
P O BOX 727
78 WEST MICHIGAN AVENUE
3750 WEST DEERFIELD ROAD
P O BOX 1999
129 E. BROADWAY
P O BOX 31716
P O BOX 27806
P O BOX 8212
POST OFFICE BOX 1138
9TH & MAIN STREETS
700 N 10TH ST
SUITE 250
P O BOX 43613
P O BOX 52949
3700 WILSHIRE BLVD.
POST OFFICE BOX 261
250 KING OF PRUSSIA ROAD
3535 UNIVERSITY BLVD W.
P O BOX 550
3130 BROADWAY
P O BOX 927
P O BOX 5000
P O BOX 13163
300 WEST ELEVENTH STREET
WORCESTER
CHARLOTTE
SEAL BEACH
CLEVELAND
SEATTLE
HOUSTON
BATON ROUGE
MA
NC
CA
OH
WA
TX
LA
01615
28201
90740
44147
98101
77292
70810
METAIRIE
WICHITA
PHOENIX
GREENVILLE
GILBERTVILLE
BROKENARROW
KANSAS CITY
LITTLE ROCK
PORTLAND
SAN ANTONIO
FAIRFAX
SAN ANTONIO
KANSAS CITY
MEMPHIS
BATTLE CREEK
RIVERWOODS
DETROIT
OWATONNA
TAMPA
BALTIMORE
LITTLE ROCK
BALTIMORE
RICHMOUND
BATON ROUGE
LA
KS
AZ
MS
NY
OK
MO
AR
OR
TX
VA
TX
MO
TN
MI
IL
MI
MN
FL
MD
AR
MD
VA
LA
70011
67202
85011
38702
13776
74013
64116
72211
97204
78218
22030
78279
64111
38194
49016
60015
48235
55060
33631
21285
72211
21203
23219
70802
BIRMINGHAM
NEW ORLEANS
LOS ANGELES
HOUMA
RADNOR
KENSINGTON
AL
LA
CA
LA
PA
MD
35243
70152
90010
70360
19087
20895
KANSAS CITY
NATCHEZ
EDEN
KANSAS CITY
KANSAS CITY
MO
MS
NC
MO
MO
64111
39120
27285
64199
64105
HEALTHCARE
DOLLAR STORES INC
HEALTH PLAN INC.(FHP)
HERITAGE LIFE INS CO
LIFE INS. CO.
LIFE INSURANCE COMPANY
MANAGED CARE-FMC
FARA BENEFIT SERVICES INC
FARM & RANCH LIFE INS. CO., INC.
FARM AND HOME LIFE INS. CO.
FARMERS GRAIN
FARMERS HEALTH AGENCY INSURANCE
FARMERS INSURANCE
FARMLAND INDUSTRIES INC
FARMLAND MID SOUTH HEALTH PLAN
FARWEST AMERICAN ASSURANCE CO.
FCE BENEFITS
FDIC / NCAS
FEDERAL CONTRACT EMPLOYEES HLTH & WELFARE FND
FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM
FEDERAL EXPRESS CORP
FEDERAL HOME LIFE INS. CO.
FEDERAL LIFE INS. CO. (MUTUAL)
FEDERAL MOGUL HEALTH CARE SYSTEM
FEDERATED LIFE INS. CO.
FEDERATED MUTUAL INSURANCE COMPANY
FELRA & UFCW HEALTH & WELFARE FUND
FEWELL AND ASSOCIATES
FIDELITY AND GUARANTY LIFE INS. CO.
FIDELITY BANKERS LIFE INS. CO.
FIDELITY FEDERAL LIFE INS. CO., INC.
2867-00
0157-00
0156-00
1486-00
1513-00
1209-00
2090-00
3019-00
0158-00
3507-00
0984-00
2425-00
2226-00
1081-00
0159-00
0160-00
2785-00
0161-00
2127-00
1808-00
1370-00
0163-00
0162-00
2427-00
FIDELITY
FIDELITY
FIDELITY
FIDELITY
FIDELITY
FIDELITY
3616-00
1573-00
0164-00
0165-00
0166-00
1496-00
FIDUCIARY COMPANY
FIRE & CASUALTY
INTERSTATE LIFE INS. CO.
LIFE INS. CO.
MUTUAL LIFE INS. CO., THE
SECURITY INS. CO.
FIDELITY SECURITY LIFE INS. CO.
FIDELITY TIRE BENEFITS FUND
FILDCREST CANNON INC
FINANCIAL ADMINISTRATION CORPORATION
FINANCIAL ASSURANCE, INC.
0167-00
2551-00
2879-00
1099-00
0168-00
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
33
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
FINANCIAL FIDELITY LIFE INS. CO.
FINANCIAL INSTITUTIONS GROUP
FINANCIAL SECURITY LIFE OF LA
FINCH BENEFIT PLAN
FIRE BOSS OF LA. (SELF-INSURED)
FIREMAN'S AMERICAN LIFE INS. CO.
FIREMANS INSURANCE
FIRESIDE MUTUAL LIFE
FIRESTONE TIRE & RUBBER COMPANY
FIRST ADMINISTRATORS
FIRST ADMINISTRATORS
FIRST ALLMERICA
0169-00
1329-00
0170-00
1250-00
1990-00
0171-00
0865-00
0735-00
0920-00
3422-00
3308-00
2954-00
SHREVEPORT
BREAUX BRIDGE
SHREVEPORT
SHREVEPORT
NEW IBERIA
SAN RAFAEL
SAN DIEGO
SHREVEPORT
AKRON
SIOUX CITY
SIOUX CITY
ITASCA
LA
LA
LA
LA
LA
CA
CA
LA
OH
IA
IA
IL
71130
70517
71130
71102
70560
94911
92138
71130
44314
51102
51102
60143
FIRST
FIRST
FIRST
FIRST
3239-00
0172-00
1743-00
2126-00
POST OFFICE BOX 3999
P O BOX 1180
6001 FINANCIAL PLAZA
3811 GILBERT AVE
1503 WEEKS ISLAND RD
1600 LOS GAMOS DRIVE
PO BOX 85566
P O BOX 33999
1200 FIRESTONE PARKWAY
P O BOX 9900
P O BOX 9900
333 PIERCE RD
SUITE 310
P O BOX 3865
POST OFFICE BOX 3258
P O BOX 879
3636 COPLEY RD/STE 201
P O BOX 4138
P O BOX 737
12940 N HWY 183
P O BOX 381686
110 GIBRALTER RD/STE 116
POST OFFICE BOX 1280
POST OFFICE BOX 618
210 BARONNE ST
POST OFFICE BOX 9249
400 S. W. SIXTH AVENUE
10621-B OAK HILL PARKWAY
POST OFFICE BOX 19685
P O BOX 873
11301 W LAKE PARK DR
P O BOX 14724
3200 HIGHLAND AVE
P O BOX 389
P O BOX 71120
P O BOX 5279
POST OFFICE BOX 26841
P O BOX 21116
7 CLAYTON STREET
P O BOX 23755
POST OFFICE BOX 30297
POST OFFICE BOX 2941
201 GLENDA STREET
3200 HIGHLAND AVE
P O BOX 1268
6001 FINANCIAL PLAZA
300 EAST FALL CREEK BLVD.
P O BOX 450
P O BOX 8077
P O BOX 690450
P O BOX 2697
NEW HYDE PARK
BATON ROUGE
ANDERSON
ARKON
NY
LA
IN
OH
11040
70821
46015
44321
TOPEKA
AUSTIN
BIRMINGHAM
HORSHAM
LYNCHBURG
COLUMBIA
NEW ORLEANS
SALT LAKE CITY
PORTLAND
BATON ROUGE
NEW ORLEANS
URBANA
MILWAUKEE
LEXINGTON
DOWNERS GROVE
DUBUQUE
BOSSIER CITY
TORRANCE
OKLAHOMA CITY
SHREVEPORT
MONTGOMERY
OAKLAND
RALEIGH
LITTLE ROCK
RAYVILLE
DOWNERS GROVE
TIFTON
SHREVEPORT
INDIANAPOLIS
PUEBLO
WAUSAU
SAN ANTONIO
WICHITA
KS
TX
AL
PA
VA
MO
LA
UT
OR
LA
LA
IL
WI
KY
IL
IA
LA
CA
OK
LA
AL
CA
NC
AR
LA
IL
GA
LA
IN
CO
WI
TX
KS
66601
78750
35238
19044
24505
65205
70160
84109
97204
70810
70179
61803
53224
40512
60515
52004
71120
90510
73126
71154
36104
94623
27612
72203
71269
60515
31793
71130
46205
81002
54402
78269
67201
AMERICAN
ASSURANCE LIFE OF AMERICA
BENEFIT CORP
BENEFITS AGENCY INC
FIRST BENEFITS INC
FIRST CARE INSURANCE
FIRST CAROLINA CARE
FIRST CHOICE INS CO
FIRST COLONY LIFE INS. CO.
FIRST COLUMBIA LIFE INS. CO.
FIRST COMMERCE CORPORATION,FIRST NBC
FIRST CONTINENTAL LIFE AND ACCIDENT INS. CO.
FIRST FARWEST LIFE INS. CO.
FIRST FIDELITY LIFE INSURANCE COMPANY
FIRST FINANCIAL LIFE INS. CO.
FIRST GUARD HEALTH PLAN
FIRST HEALTH
FIRST HEALTH
FIRST HEALTH
FIRST HEALTH NETWORK
FIRST HEALTH NETWORK
FIRST INTEGRATED HEALTH
FIRST LIFE ASSURANCE CO.
FIRST NATIONAL BANK OF SHREVEPORT
FIRST NATIONAL LIFE INS. CO.
FIRST PACIFIC LIFE INSURANCE CO
FIRST PROTECTION LIFE INS. CO.
FIRST PYRAMID LIFE INS. CO. OF AMERICA, THE
FIRST REPUBLIC BANK
FIRST RX
FIRST SOUTHEAST RISK
FIRST UNITED LIFE INS. CO.
FIRSTMARK STANDARD LIFE INS. CO.
FISERV HEALTH
FISERV HEALTH
FISERV HEALTH
FISERV HEALTH-KANSAS
1246-00
3293-00
3973-00
1474-00
0173-00
0174-00
1239-00
0175-00
0176-00
1786-00
0177-00
3282-00
2307-00
3819-00
3565-00
3699-00
4088-00
2634-00
0178-00
0894-00
0180-00
1640-00
0181-00
0182-00
2562-00
3392-00
0796-00
0183-00
0179-00
3435-00
3434-00
3371-00
3303-00
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
34
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
FISERV HEALTH-TENNESSEE
FISERV WAUSAU
FIZER V HEALTH
3229-00
4033-00
3656-00
P O BOX 305154
P O BOX 30541
NASHVILLE
SALT LAKE CITY
WAUSAU
TN
UT
WI
37230
84130
54022
FLEET RESERVE ASSOCIATION
FLEMING GUARDIAN GROUP
FLEX PLUS
FLEX-LINC HEALTH PLAN
FLEXMED
FLEXMED
FLORIDA COMMERCIAL TRUST
FLORIDA HEALTH ALLIANCE
FLORIDA HOSPITAL HEALTHCARE SYSTEM
FLORIDA LIFE INS. CO.
FLORIDA WEST COAST TRAVEL TRADES
2176-00
1481-00
1470-00
1224-00
3715-00
3663-00
1646-00
2248-00
3711-00
0184-00
2497-00
DES MOINES
OKLAHOMA CITY
HAMPTON
MARYLAND HEIGHTS
RICHARDSON
CHARLESTON
MIAMI
JACKSONVILLE
ORLANDO
MIAMI
TAMPA
IA
OK
NH
MO
TX
SC
FL
FL
FL
FL
FL
50398
73126
03842
63043
75085
29413
33100
32247
32553
33143
33612
FMH BENEFIT SERVICES
FMH BENEFITS, INC
FOOD LION BENEFIT PLAN
FORD LIFE INS. CO.
FOREIGN MISSION BOARD OF THE SO. BAPTIST CONV.
FOREIGN SERVICE BENEFIT PLAN
3295-00
2960-00
2339-00
0185-00
2504-00
3266-00
OVERLAND PARK
OVERLAND PARK
CHARLESTON
DEARBORN
RICHMOND
WASHINGTON
KS
KS
WV
MI
VA
DC
66225
66225
25339
48121
23230
20415
FOREMOST LIFE INS. CO.
FOREST OIL CORP. MEDICAL & DENTAL PLANS
FORREST T JONES & COMPANY
FORTIS BENEFITS
0186-00
2725-00
3925-00
2114-00
GRAND RAPIDS
ENGLEWOOD
KANSAS CITY
KANSAS CITY
MI
CO
MO
MO
49501
80112
64141
64141
FOUNDATION BENEFITS ADMINISTRATORS
FOUNDATION HEALTH
3375-00
2567-00
AUSTIN
NEW ORLEANS
TX
LA
78730
70130
FOUNDERS LIFE ASSURANCE CO. OF FL
FOUNTAIN VALLEY MEDICAL CENTER (HMO) FHP INC
FOUNTAINHEAD ADM.
FOX EVERETT INC.
FRANK GATES SERVICE CO;DELTA QUEEN
0187-00
2577-00
2723-00
1367-00
0918-00
TAMPA
FOUNTAIN VALLEY
BIRMINGHAM
JACKSON
COLUMBUS
FL
CA
AL
MS
OH
33601
92708
35202
39205
43216
FRANK'S CASING CREW & RENTAL TOOLS INC
FRANKLIN LIFE INS. CO., THE
FREEDOM LIFE
FREEDOM LIFE INS CO OF AMERICA
FREEDOM LIFE INUSRANCE COMPANY
FREEPORT-MCMORAN INC
2272-00
0188-00
1421-00
3623-00
4024-00
2578-00
LAFAYETTE
SPRINGFIELD
LOUISVILLE
FORT WORTH
ARLINGTON
RICHARDSON
LA
IL
KY
TX
TX
TX
70505
62705
40224
76102
76004
75083
FRESENIUS MEDICAL CARE HEALTH PLAN
FRINGE BENEFIT PLANS INC-HERMITAGE INSURANCE
FRINGE BENEFITS MANAGEMENT COMPANY
FUGRO INC/EMPLOYEE BENEFIT SERVICES
FUNDING BENEFITS (LAFAYETTE PARISH GOVT )
FUNDING BENEFITS ADMINISTRATIVE SERVICES
FUTURE SCRIPTS
3798-00
0800-00
3318-00
2636-00
0927-00
0760-00
4123-00
HOUSTON
SHREVEPORT
ORMOND
SHREVEPORT
METAIRIE
HOUMA
KANSAS CITY
TX
LA
FL
LA
LA
LA
MO
77274
71104
32173
71137
70010
70364
64141
P O B OX 8077
400 LOCUST ST/8TH FLOOR
P O BOX 26647
P O BOX 6000
SO.AMERICAN INDUSTRIAL DR
P O BOX 853925
P O BOX 22557
P O BOX 432773
P O BOX 10269
P O BOX 536847
6600 RED ROAD
ADMINISTRATIVE SERV. INC
12421 N FLORIDA/STE D-203
P O BOX 25946
P O BOX 25946
P O BOX 11604
THE AMERICAN ROAD
P O BOX 6767
OFFICE OF PERSONNEL MGMT
1900 E STREET NW
POST OFFICE BOX 2450
16 INVERNESS PLACE E BLDA
P O BOX 418131
PROSTAFF INC
P O BOX 419876
6300 BRIDGEPOINT PKWY
605 POYDRAS ST
STE 2220
POST OFFICE BOX 1571
9930 TALBERT AVE
P O BOX 2568
P O BOX 188
STEAMBOAT BENEFIT TRUST
PO BOX 16580
P O BOX 51729
FRANKLIN SQUARE
P O BOX 24294
801 CHERRY ST/UNIT 33
P O BOX 1468
P O BOX 833843
1661 GATEWAY BLVD
P O BOX 741107
3811 GILBERT ST
P O BOX 730561
P O BOX 70100
PO BOX 7325
2324 HWY 316
P O BOX 384
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
35
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
G & G DISTRIBUTORS CORP
G E PENSIONER INS
G.M. UNDERWRITERS
G.M.P.-EMPLOYERS RETIRE TRUST
GA/PPO
0709-00
0763-00
2071-00
1787-00
2155-00
BOSSIER
UTICA
ROCHESTER
FORT MEYERS
NEW ORLEANS
LA
NY
MI
FL
LA
71171
13503
48308
33907
70113
GALAXIA LIFE INSURANCE CO
1560-00
DALLAS
TX
75749
GALAXY MARINE SERVICE EMPLOYEE BENEFIT TRUST
GALBRAITH & GREEN
2553-00
0510-00
PATTERSON
HOUSTON
LA
TX
70392
77067
GALLAGER-BASSETT
GALLAGHER BENEFITS
GALLAGHER BOLLINGER
GALLIANO MARINE SERVICE HEALTH INSURANCE PLAN
GARAN
GARCO DENTAL
GARDEN STATE LIFE INS. CO.
GARDNER & WHITE
GARDNER DENVER
1728-00
3085-00
4058-00
2784-00
1817-00
2794-00
0189-00
0511-00
3200-00
SAN ANTONIO
LISLE
MORRISTOWN
GALLIANO
KAPLAN
CARMEL
WASHINGTON
INDIANAPOLIS
TX
IL
NJ
LA
LA
IN
DC
IN
IA
78265
60532
07962
70354
70548
46032
20076
46240
52004
GATEWAY HEALTH PLAN
3156-00
PITTSBURGH
PA
15219
GATHINGS INSURANCE SERVICES
GEHA
GEHA
GEHA (PCIP)
GEICO GENERAL INSURANCE
GEISENGER HEALTH PLAN
GEM INSURANCE
GENELCO
GENERAL AMERICAN
GENERAL AMERICAN LIFE INSURANCE COMPANY
GENERAL CONFERENCE OF SEVENTH-DAY ADVENTISTS
GENERAL ELECTRIC GROUP ADMINISTRATORS
GENERAL LIFE AND ACCIDENT INSURANCE CO
GENERAL MILLS INC
GENERAL SERVICES LIFE INS. CO.
GENERATING HEALTHCARE
GENESCO INC
GENMAR INDUSTRIES CORP GROUP SYSTEMS
GENWORTH FINANCIAL
GENWORTH LIFE AND HEALTH INSURANCE
GEOPHYSICAL SERVICE INC
3447-00
4116-00
3593-00
3855-00
3263-00
2729-00
2909-00
2013-00
0974-01
0974-00
2360-00
3070-00
0902-00
2018-00
0190-00
3838-00
1853-00
2153-00
3622-00
3368-00
1440-00
RIDGELAND
INDEPENDENCE
INDEPENDENCE
INDEPENDENCE
WASHINGTON
DANVILLE
LUBBOCK
FT WORTH
ST LOUIS
KENNETT
SILVER SPRINGS
ARLINGTON
FORT WORTH
MINNEAPOLIS
WASHINGTON
HOUSTON
NASHVILLE
LIVONIA
CLEARWATER
LYNCHBURG
DALLAS
MS
MO
MO
MO
DC
PA
TX
TX
MO
MO
MD
TX
TX
MN
DC
TX
TN
MI
FL
VA
TX
39158
64051
64051
64061
20076
17822
79453
76101
63178
63857
20914
76015
76109
55440
20006
77274
37202
48151
33757
24506
75265
GEORGE H LEHLEITNER CO INC
GEORGE WASHINGTON LIFE INS. CO.
GEORGETOWN BENEFITS INSURANCE
0932-00
0191-00
1032-00
NEW ORLEANS
JACKSONVILLE
ATLANTA
LA
FL
GA
70183
32203
30358
GEORGIA HEALTHCARE PARTNERSHIP INC
2658-00
P O BOX 6295
P O BOX 7777
P O BOX 5004
5245 BIG PINE WAY S.E.
639 LOYOLA AVE
SUITE 860
P O BOX 749028
LBJ FREEWAY
P O BOX 189
350 GLENBOROUGH DR.
SUITE 100
P O BOX 34297
P O BOX 5227
P O BOX 1346
17483 E MAIR ST
302 CLAVEY MEAUX RD
P O BOX 1917
GEICO PLAZA, 6T
P O BOX 40619
P O BOX 389
DUBUQUE
TWO CHATHAM CENTER
SUITE 500
P O BOX 960
P O BOX 2336
P O BOX 4665
P O BOX 300
ONE GEICO PLAZA
DANVILLE OFFICE BLDG
P O BOX 53010
P O BOX 901030
P O BOX 14458
719 TEACO ROAD
P O BOX 4759
P O BOX 150809
P O BOX 11218
P O BOX 1113
1701 PENNSYLVANIA AVE NW
P O BOX 740949
RM 436 GENESCO PARK
P O BOX 2908
P O BOX 10821
P O BOX 40011
SELF INSURED
P O BOX 655621
PO BOX
POST OFFICE BOX 4214
HOME DEPOT
PO BOX 720677
7135 HODGSON MEMORIAL DR
SUITE 9
SAVANNAH
GA
31406
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
36
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
GEORGIA INTERNATIONAL
1082-00
JACKSON
MS
39216
GEORGIA INTERNATIONAL LIFE INS.CO.
GEORGIA LIFE AND HEALTH INS. CO.
GEORGIA PACIFIC CORPORATION (PAPER-GROUP INS)
GERBER LIFE
GERBER LIFE INS. CO.
GILSBAR
GILSBAR
GILSBAR
GILSBAR INC
GLENWOOD REGIONAL MEDICAL CENTER
GLOBAL EXCEL MANAGEMENT
GLOBAL HEALTH
GLOBAL INSURANCE MANAGEMENT & CONSULTANTS
GLOBAL MARINE,INC.HEALTH CARE PLAN
GLOBAL SANTA FE
GLOBE LIFE & ACCIDENT INS. CO.
1093-00
1429-00
1072-00
4008-00
0192-00
4089-00
3743-00
3439-00
0935-00
1994-00
3916-00
3746-00
1307-00
1351-00
3505-00
0193-00
ATLANTA
ATLANTA
CROSSETT
OMAHA
WHITE PLAINS
COVINGTON
COVINGTON
LUBBOCK
COVINGTON
MONROE
BEEBE PLAIN
OKLAHOMA CITY
ROANOKE
HOUSTON
EL PASO
OKLAHOMA CITY
GA
GA
AR
NE
NY
LA
LA
TX
LA
LA
VT
OK
VA
TX
TX
OK
30357
30301
71635
68103
10601
70434
70434
79408
70434
71207
05823
73101
24012
77218
79998
73184
GLOBE LIFE INS. CO.
GM SOUTHWEST
GODWINS BOOKE & DICKENSON
GOLDEN RULE
GOLDEN RULE
GOLDEN RULE INSURANCE
GOLDEN STATE MUTUAL LIFE INS. CO.
0194-00
3497-00
2608-00
3639-00
0195-00
0784-00
0196-00
CHICAGO
FRISCO
WINSTON-SALEM
INDIANAPOLIS
LAWRENCEVILLE
LAFAYETTE
LOS ANGELES
IL
TX
NC
IN
IL
LA
CA
60601
75034
27102
46278
62439
70503
90054
GOLDEN TRIANGLE HEALTHCARE MGMT
GOOD HEALTH TRUST
GOOD SAMARITAN PROGRAM
GOODYEAR TIRE AND RUBBER CO
GOVERNMENT EMPLOYEES HOSPITAL ASSOCIATION
GOVERNMENT PERSONNEL MUTUAL LIFE INS. CO.
GRAND CASINO HEALTH PLAN
GRAND ISLE SHIPYARD INC
GRASSO CORPORATION
2840-00
1392-00
1615-00
1046-00
0727-00
0197-00
2596-00
2413-00
2359-00
NEDERLAND
LAKELAND
BEECH GROVE
AKRON
INDEPENDENCE
SAN ANTONIO
MINNEAPOLIS
GRAND ISLE
HOUSTON
TX
FL
IN
OH
MO
TX
MN
LA
TX
77627
33802
46107
44316
64051
78216
55440
70358
77042
GRAY INS CO
GREAT AMERICAN CORPORATION BENEFIT SERVICE
GREAT AMERICAN LIFE INSURANCE CO.
GREAT AMERICAN RESERVE INS. CO.
GREAT CENTRAL LIFE INS. CO.
GREAT LAKES HEALTH CARE BENEFITS PLAN
GREAT NORTHWESTERN LIFE INSURANCE CO
1586-00
1007-00
0198-00
0199-00
0200-00
1559-00
1504-00
LAFAYETTE
BATON ROUGE
CINCINNATI
DALLAS
OAKDALE
WEST LAFAYETTE
NORCROSS
LA
LA
OH
TX
LA
IN
GA
70505
70821
45201
75221
71463
47906
30093
GREAT
GREAT
GREAT
GREAT
GREAT
GREAT
1749-00
1461-00
0201-00
0202-00
2607-00
2540-00
C/O ENGINEERING SERVICES
P O BOX 4632
PO BOX 7325
P O BOX 1676
P O BOX 520
P O BOX 2271
66 CHURCH STREET
P O BOX 2947
P O BOX 5470
P O BOX 9802
PO BOX 2947
P O BOX 2175
P O BOX 10
P O BOX 2328
P O BOX 5053
P O BOX 218969
P O BOX 981502
120 ROBERT S KERR
GLOBE LIFE CENTER
222 NORTH DEARBORN STREET
P O BOX 6000
P O BOX 15
7440 WOODLAND DR
712 11TH ST
515 S COLLEGE RD
POST OFFICE BOX 2332
TERMINAL ANNEX
P O DRAWER 1366
P O BOX 988
P O BOX 279
1144 EAST MARKET ST D609
P O BOX 4665
POST OFFICE BOX 32266
P O BOX 1459
P O BOX 1000
11111 WILCREST GREEN
SUITE 300
P O BOX 53348
P O BOX 591
P O BOX 5420
2020 LIVE OAK STREET
POST OFFICE BOX 687
P O BOX 2200
GROUP CLAIMS CENTER
1500 OAKBROOK DR./STE 540
470 SOUTH PATTERSON AVE
P O BOX 306
6001 FINANCIAL PLAZA
POST OFFICE BOX 1972
P O BOX 52707
GROUP INSURANCE OFFICE
P O BOX 44
SANTA BARBARA
ST JOSEPH
SHREVEPORT
HOUSTON
LAFAYETTE
CEDAR SPRINGS
CA
LA
LA
TX
LA
GA
93111
71366
71130
77251
70505
31732
REPUBLIC INSURANCE
RIVER GRAIN (SELF-INSURED)
SOUTHEASTERN LIFE INS. CO.
SOUTHERN LIFE INS. CO.
SOUTHERN OIL & GAS INC
SOUTHERN PAPER COMPANY
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
37
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
GREAT SOUTHWEST LIFE INS. CO.
GREAT WEST HEALTH CARE
GREAT WEST HEALTH CARE
0203-00
3553-00
3474-00
HOUSTON
KENNETT
NEW ORLEANS
TX
MO
LA
77052
63857
70163
GREAT WEST HEALTH PLAN
GREAT WEST LIFE HEALTH
GREAT WEST/PHCS
1935-00
2151-00
3654-00
LAFAYETTE
KENNETT
NEW ORLEANS
LA
MO
LA
70505
63857
70163
GREAT WESTERN LIFE
GREAT-WEST CARE
2073-00
1929-00
BEAUMONT
ATLANTA
TX
GA
77726
30326
GREAT-WEST CARE HEALTH PLAN
GREAT-WEST LIFE ASSURANCE CO., THE
GREEN TREE ADMINISTRATORS
GREEN TREE ADMINISTRATORS
GREY WOLF DRILLING
1815-00
0204-00
1485-00
3880-00
1723-00
TAMPA
DENVER
CARNEGIE
BEAUMONT
HOUSTON
FL
CO
PA
TX
TX
33631
80201
15106
77726
77056
GREYHOUND LINES INC
GROUP ADMINISTRATORS INC
GROUP ADMINISTRATORS LTD
GROUP AND PENSION ADMINISTRATORS
GROUP AND PENSION ADMINISTRATORS INC
GROUP BENEFIT ADMINISTRATORS
GROUP BENEFITS UNLIMITED
1095-00
1958-00
3456-00
3546-00
2610-00
1680-00
2882-00
PHOENIX
DALLAS
SCHAUMBURG
DALLAS
RICHARDSON
RIVER EDGE
ARLINGTON HEIGHTS
AZ
TX
IL
TX
TX
NJ
IL
85064
75231
60173
75374
75080
07661
60004
GROUP DENTAL SERVICES
GROUP EXECUTIVE MARKETING INC
1315-00
3073-00
NORTH BETHESDA
TAMPA
MD
FL
20895
33675
GROUP
GROUP
GROUP
GROUP
GROUP
3363-00
3664-00
2430-00
0751-00
3511-00
POST OFFICE BOX 53330
1000 GREAT WEST DRIVE
1100 POYDRAS ST
STE 2600
P O BOX 51729
1000 GREAT WEST DR
1100 POYDRAS ST
#2600
P O BOX 1080
3340 PEACHTREE RD NE
SUITE 2295
P O BOX 31251
POST OFFICE BOX 1080
P O BOX 759
P O BOX 7306
1980 POST OAK BLVD
#1150
P O BOX 32419
10440 N CENTRAL EXPY
450 E REMINGTON RD
P O BOX 749075
300 MUNICIPAL DR
70 GRAND AVE
3800 N WILKE
SUITE 200
11301 ROCKVILLE PIKE
CCN PPO
P O BOX 5190
P O BOX 370
P O BOX 34585
P O BOX 34750
221 PARK AVE S
550 MARYVILLE CENTRE DRIV
SUITE 300
111 CORPORATE OFFICE
DR. 4
P O BOX 431890
9201 E BLOOMINGTON FWY
205 W WACKER DR
ONE POYDRAS PLAZA
639 LOYOLA AVE/STE 1360
10877 WATSON ROAD
P O BOX 20593
P O BOX 1180
TENSAS MEMORIAL HOSPITAL
TPA,INC BOX N
P O BOX 100043
P O BOX 450367
P O BOX 4503
8801 INDIAN HILLS DR
530 RIVER OAKS WEST
GALLIANO
SEATTLE
SEATTLE
NEW YORK 3
ST LOUIS
LA
WA
WA
NY
MO
70354
98124
98124
10027
63141
EARTH CITY
MO
63045
SO MIAMI
BLOOMINGTON
CHICAGO
NEW ORLEANS
FL
MN
IL
LA
33243
55420
60606
70113
ST. LOUIS
INDIANAPOLIS
BREAUX BRIDGE
LUDLOW
MO
IN
LA
MA
63121
46220
70517
01056
DULUTH
ATLANTA
AGANA
OMAHA
CALUMET CITY
GA
GA
GU
NE
IL
30096
30345
96910
68114
60409
HEALTH
HEALTH
HEALTH
HEALTH
HEALTH
ALLIANCE
ALLIANCE
CO-OP OF PUGENT SOUND HLTH PLAN
INSURANCE INC
PLAN
GROUP HEALTH PLAN
3385-00
GROUP
GROUP
GROUP
GROUP
INS CONSULTANT FLORIDA EMPLOYERS TRUST
INS SERVICE CTR INC
INSURANCE ADMINISTRATION
INSURANCE ADMINISTRATION OF LA. INC
0787-00
1905-00
0791-00
2301-00
GROUP
GROUP
GROUP
GROUP
INSURANCE COMPANY
LINK
PROGRAMS
RENTAL INSURANCE PROGRAM
1845-00
3334-00
1394-00
1267-00
GROUP RESOURCES
GROUP RESOURCES INC
GUAM MEMORIAL HEALTH PLAN
GUARANTEE MUTUAL LIFE INS CO
GUARANTEE RESERVE LIFE INS. CO.
3460-00
1799-00
2002-00
1973-00
0205-00
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
38
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
GUARANTEE TRUST LIFE
GUARANTY BANK & TRUST CO, EMPLOYEE GROUP INS
GUARANTY INCOME LIFE INS. CO.
GUARDIAN
GUARDIAN
GUARDIAN
GUIDESTAR HEALTH SYSTEM
GULF ATLANTIC LIFE INS. CO.
GULF COAST LINES EMPLOYEES HOSPITAL ASSC
GULF EMPLOYERS TRUST PLAN ADMIN
GULF GROUP SERVICE
GULF GUARANTY HEALTH INSURANCE
GULF LIFE INS. CO.
GULF SERVICES INC
GULF SOUTH ADMINISTRATORS
0206-00
0883-00
0207-00
3534-00
0208-00
1909-00
2941-00
0209-00
1313-00
2078-00
0705-00
2314-00
0211-00
2347-00
2810-00
GLENVIEW
LAFAYETTE
BATON ROUGE
SPOKANE
APPLETON
APPLETON
BIRMINGHAM
SAN FRANCISCO
HOUSTON
CORPUS CHRISTI
BATON ROUGE
JACKSON
JACKSONVILLE
BATON ROUGE
METAIRIE
IL
LA
LA
WA
WI
WI
AL
CA
TX
TX
LA
MS
FL
LA
LA
60025
70501
70821
99210
54912
54912
35238
94119
77006
78411
70895
39236
32201
70898
70011
GULF SOUTH BEVERAGE EMPLOYEES BENEFIT PLAN
1001-00
NEW ORLEANS
LA
70183
GULF SOUTH HEALTH PLAN
1200-00
BATON ROUGE
LA
70808
GULF
GULF
GULF
GULF
1131-00
3533-00
3026-00
3319-00
P O BOX 1144
P O BOX 3248
POST OFFICE BOX 2231
P O BOX 2459
P O BOX 8007
P O BOX 8024
P O BOX 385012
POST OFFICE BOX 3892
1601 WEST ALABAMA
5656 S STAPLES ST/STE 330
P O BOX 15349
P O BOX 14977
POST OFFICE BOX 1050
P O BOX 14449
P O BOX 8570
3616 S I-10 SERVICE ROAD
OF THE SOUTH
P O BOX 2352
5615 CORPORATE BLVD
STE 5A
5615 CORPORATE BLVD
P O BO 1398
P O BOX 3857
2325 WEYMOUTH DR
STE A
POST OFFICE DRAWER 157
P O BOX 120539
ONE PLAZA EAST
SUITE 1100
P O BOX 863
TOWER LIF BLDG
BATON ROUGE
HOUMA
HOUMA
BATON ROUGE
LA
LA
LA
LA
70808
70361
70361
70809
MARKSVILLE
NASHVILLE
MILWAUKEE
LA
TN
WI
71351
37212
53202
INDIANAPOLIS
SAN ANTONIO
ORLANDO
GREENVILLE
LAS VEGAS
ROANOKE
SHREVEPORT
COSTA MESA
IN
TX
FL
SC
NV
VA
LA
CA
46206
78205
32887
29606
89104
24022
71130
92626
DUNCAN
WESTMONT
LAFAYETTE
IRVING
OK
IL
LA
TX
73534
60559
70506
75039
COVINGTON
BATON ROUGE
SCOTTSDALE
LA
LA
AZ
70433
70821
85250
TAMPA
DAYTON
SALT LAKE CITY
HOUSTON
FL
OH
UT
TX
33631
45401
84130
77002
SOUTH HEALTH PLAN
SOUTH RISK SERVICES
SOUTH RISK SERVICES
STATES LTAC
GULFCO LIFE INS. CO.
GULFSOUTH PRINTING & SPECIALTIES INC
GUSTCO GROUP INSURANCE
0210-00
1339-00
1008-00
H C C LIFE INS CO
H.B. ZACHRY CO & AFFILIATES GROUP MEDICAL PLANS
H.B.J. INSURANCE CO
H.D.R. EMPLOYEES BENEFITS ADMINISTRATION
H.E.R.E.I.U. WELFARE FUND
H.L. DUKE AND CO.
HAAB SECURITY LIFE INS. CO.
HALLER ASSOCIATES
3648-00
2262-00
1638-00
2091-00
2437-00
1544-00
0212-00
2788-00
HALLIBURTON CO EMPLOYEES TRUST MED PLAN OFFICE
HALLMARK INS ADMIN INC
HAMILTON HEALTH PLAN
HAMMERMAN & GRAINER INC
1264-00
1401-00
1247-00
3868-00
HAMMONS & ASSOCIATES
HANCOCK BANK OF LOUISIANA
HARDEN & COMPANY OF ARIZONA
2564-00
1793-00
2993-00
HARMONY HEALTH PLAN OF MISSOURI
HARRINGTON BENEFIT SERVICES INC
HARRINGTON HEALTH
HARRIS COUNTY OFFICE OF RISK MANAGEMENT
3345-00
2679-00
3770-00
2925-00
P O BOX 5150
1933 LAS VEGAS BLVD SO.
P O BOX 12225
6001 FINANCIAL PLAZA
2755 BRISTOL ST
SUITE 250
P O BOX 6000
800 QUAIL RIDGE DR
4212 W CONGRESS
909 LAKE CAROLYN PKWY
STE 1900
CLAIBORNE OAKS OFFICE PK
P O BOX 591
15721 N GREENWAY HADEN LP
SUITE 205
P O BOX 31370
P O BOX 1352
P O BOX 30544
1310 PRAIRIE ST
SUITE 1207
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
39
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
HARRIS METHODIST HEALTH PLAN
HARTFORD LIFE AND ACCIDENT INS. CO.
HARTFORD LIFE INS. CO.
HARVARD PILGRIM INSURANCE
HARVEYS HEALTH CLAIMS MANAGEMENT
HAWAII MEDICAL SERVICE ASSOCIATION
HAWKEYE NATIONAL LIFE INS. CO.
HBS GROUP (HARRINGTON BENEFIT SERVICES)
HCC LIFE INSURANCE COMPANY
HEALTH ADMINISTRATION SERVICES,INC
2573-00
0213-00
0214-00
3306-00
2904-00
1960-00
0215-00
2692-00
4126-00
1423-00
ARLINGTON
HARTFORD
HARTFORD
QUINCY
STATELINE
HONOLULU
DES MOINES
WESTERVILLE
FAMINGTON HILLS
HOUSTON
TX
CT
CT
MA
NV
HI
IA
OH
MI
TX
76011
06115
06115
02269
89449
96808
50322
43081
48333
77067
HEALTH
HEALTH
HEALTH
HEALTH
HEALTH
1790-00
1632-00
H231-20
0722-00
1968-00
611 RYAN PLAZA DR
HARTFORD PLAZA
HARTFORD PLAZA
P O BOX 699183
P O BOX 4470
P O BOX 860
8350 HICKMAN ROAD, STE. A
P O BOX 6133
P O BOX 2005
12600 NORTHBOROUGH
SUITE 300
P O BOX 22255
2850 WEST GRAND BLVD
2850 WEST GRAND BLVD
5425 BRITTANY DR
4919 MEMORIAL HWY
SUITE 100
P O BOX 21109
P O BOX 691987
839 ST CHARLES AVE
STE 100
P O BOX 3970
P O BOX 8674
1201 S SHERMAN SUITE 200
5 E JACKSON BLVD
2727 PACES FERRY RD NW
SUITE 2-400
233 N MICHIGAN AVE
P O BOX 2347
P O BOX 24870
410 N 44TH ST
STE 510
P O BOX 273940
P O BOX 45018
P O BOX 224767
P O BOX 1439
P O BOX 2583
P O BOX 922001
8500 NORMANDALE LAKE BLVD
950 E PACES FERRY ROAD NE
SUITE 975
P O BOX 69355
P O BOX 130217
P O BOX 307
P O BOX 11088
P O BOX 16707
P O BOX 419104
7 WEST 34TH ST
304 NORTH MAIN ST
P O BOX 419104
P O BOX 3369
SHREVEPORT
DETRIOT
DETROIT
BATON ROUGE
TAMPA
LA
MI
MI
LA
FL
71120
48202
48202
70808
33614
ROANOKE
SAN ANTONIO
NEW ORLEANS
VA
TX
LA
24018
78269
70130
LAFAYETTE
METAIRIE
RICHARDSON
CHICAGO
ATLANTA
LA
LA
TX
IL
GA
70502
70011
75081
60604
30339
CHICAGO
YORK
OKLAHOMA CITY
PHOENIX
IL
PA
OK
AZ
60601
71405
73124
85008
BOCARATON
FRESNO
DALLAS
HENDERSONVILLE
HUDSON
HOUSTON
BLOOMINGTON
ATLANTA
FL
CA
TX
TN
OH
TX
MN
GA
33427
93718
75222
37077
44236
77292
55437
30326
HARRISBURG
TYLER
LOWELL
CHARLOTTE
JACKSON
ST LOUIS
NEW YORK
ROCKFORD
ST LOUIS
COVINGTON
PA
TX
MA
NC
MS
MO
NY
IL
MO
LA
17106
75713
01854
28220
39236
63141
10001
61101
63141
70434
ADVANTAGE
ALLIANCE PLAN
ALLIANCE PLAN
AMERICA
AND LIFE INSURANCE CO. OF AMERICA
HEALTH AND WELFARE PLAN
HEALTH CARE ADMINISTRATION
HEALTH CARE ADVANTAGE
3776-00
3366-00
1167-00
HEALTH
HEALTH
HEALTH
HEALTH
HEALTH
CARE
CARE
CARE
CARE
CARE
2953-00
2641-00
1688-00
1529-00
2439-00
HEALTH
HEALTH
HEALTH
HEALTH
CARE SERVICES CORPORATION
CENTRAL PREFERRED
CHOICE
CHOICE GENERATIONS
2227-00
2934-00
2899-00
H558-70
HEALTH
HEALTH
HEALTH
HEALTH
HEALTH
HEALTH
HEALTH
HEALTH
CLAIM SERVICES
COMP
CORP INTERNATIONAL
COST SOLUTION/WC BEELER
DESIGN PLUS
ECONOMICS
EZ
FIRST
1992-00
3159-00
3286-00
3207-00
3300-00
1210-00
3152-00
1922-00
HEALTH
HEALTH
HEALTH
HEALTH
HEALTH
HEALTH
HEALTH
HEALTH
HEALTH
HEALTH
FIRST
FIRST TPA
FLEX
GRAM
INSURANCE EXCHANGE
INSURANCE EXCHANGE
INSURANCE PLAN OF GREATER NEW YORK
LIFE AMERICA
LINK, INC
MANAGEMENT ASSOCIATES INC
3833-00
3454-00
2343-00
3979-00
0029-58
2958-00
2493-00
2107-00
2959-00
3199-00
ALLIANCE
ASSOCIATES INC
BENEFITS
INTERNATIONAL
PLAN MANAGEMENT SERVICES
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
40
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
HEALTH MARK
HEALTH MARKETS
HEALTH NET
2123-00
H784-50
1574-00
MEMPHIS
HARRISBURG
HOUSTON
TN
PA
TX
38187
17110
77074
HEALTH NET COMMUNITY SOLUTIONS
HEALTH NEW ENGLAND
4091-00
3713-00
RANCH CORDOVA
SPRINGFIELD
CA
MA
95670
01144
HEALTH NOW
HEALTH PARTNERS
HEALTH PLAN OF AMERICA
4129-00
3951-00
1567-00
EAGAN
MINNEAPOLIS
ORANGE
MN
MN
CA
55121
55440
92668
HEALTH
HEALTH
HEALTH
HEALTH
HEALTH
PLAN OF NEVADA
PLAN SERVICES
PLAN SOLUTIONS
PLANS INC
PLUS
2593-00
2771-00
3373-00
3830-00
2611-00
LAS VEGAS
OKLAHOMA CITY
SALT LAKE CITY
WESTBOROUGH
ALBUQUERQUE
NV
OK
UT
MA
NM
89114
73126
84109
01581
87125
HEALTH
HEALTH
HEALTH
HEALTH
HEALTH
HEALTH
HEALTH
HEALTH
HEALTH
HEALTH
HEALTH
HEALTH
HEALTH
HEALTH
HEALTH
HEALTH
PLUS OF LOUISIANA
PLUS OF LOUISIANA
PLUS OF LOUISIANA
PLUS OF MI
PRO SERVICE
RISK MANAGEMENT INC
SCOPE BENEFITS
SELECT
SMART
SMART/CIGNA
SOLUTIONS
SOURCE
SOURCE PROVIDENT
SOUTH CORP
SPECIAL RISK
SPECIAL RISK, INC.
2789-00
3425-00
3768-00
3393-00
0993-00
2556-00
3982-00
3432-00
3079-00
4114-00
3786-00
2616-00
2736-00
2719-00
3567-00
3192-00
P O BOX 171823
P O BOX 69349
9494 SOUTHWEST FREEWAY
SUITE 300
11971 FOUNDATION PLACE
ONE MONARCH PLACE
SUITE 1500
P O BOX 211034
P O BOX 1289
505 S MAIN ST
STE 300
P O BOX 15645
P O BOX 26410
P O BOX 9554
P O BOX 5199
7500 JEFFERSON NE CTYD II
P O BOX 27489
P O BOX 30300
P O BOX 69316
P O BOX 32625
P O BOX 1700
PO BOX 1870
P O BOX 1479
1000 GREAT WEST DR
P O BOX 660044
P O BOX 53010
P O BOX 900
P O BOX 3232
P O BOX 6115
P O BOX 219700
P O BOX 13188
P O BOX 118098
4001 N. JOSEY LANE
CARROLLTON
P O BOX 2000
2 CHASE CORPORATE DE
SUITE 300
2809 DAVIS AVE
104 INVERNESS CENTER
P O BOX 15189
3920 DAYTON BLVD
114 MARKET ST
SUITE 210
P O BOX 4925
P O BOX 3090
P O BOX 85008
P O BOX 1478
3838 N CAUSEWAY/STE 220
P O BOX 45018
25 BROADWAY
9TH FLOOR
SHREVEPORT
HARRISBURG
SHREVEPORT
FLINT
INDIANAPOLIS
MINNEAPOLIS
KENNETT
DALLAS
LUBBOCK
ELYRIA
ENGLEWOOD
INDIANAPOLIS
HOUSTON
BIRMINGHAM
CARROLLTON
LA
PA
LA
MI
ID
MN
MO
TX
TX
OH
CA
IN
TX
AL
TX
TX
71130
17105
71130
48501
46206
55440
63857
75266
79453
44036
80155
46206
77218
35202
75011
75007
NASHVILLE
HOOVER
TN
AL
37202
35244
PASCAGOULA
BIRMINGHAM
CHATTANOOGA
MS
AL
TN
39581
35242
37415
ROANOKE
VA
20411
LANCASTER
SCOTTSDALE
BELLVUE
MINNEAPOLIS
METAIRIE
FRESNO
NEW YORK
PA
AZ
WA
MN
LA
CA
NY
17604
85271
98015
55440
70002
93718
10004
HEALTH SPRING
HEALTH SPRING OF ALABAMA
H440-70
3961-00
HEALTH STAR
HEALTH STATEGIES
HEALTH STREAM CORP
2875-00
2566-00
1416-00
HEALTH/WELFARE BENEFIT SYSTEM
2756-00
HEALTHCARE COMMUNICATORS INC
HEALTHCARE COMPARE AFFORDABLES
HEALTHCARE MGMT ADMINISTATORS
HEALTHCARE NETWORK OF ACADIANA
HEALTHCARE SELECT/PHN
HEALTHCOMP ADMINISTRATORS INC
HEALTHFIRST
2821-00
2526-00
3923-00
3125-00
3609-00
3110-00
3957-00
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
41
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
HEALTHFIRST
H335-90
NEW YORK
NY
10004
HEALTHLINE
2287-00
MINNEAPOLIS
MN
55042
HEALTHMARKETS CARE ASSURED
HEALTHMASTER
3569-00
1340-00
PHILADELPHIA
NASHVILLE
PA
TN
19101
37203
HEALTHNET CALIFORNIA
HEALTHPLAN SERVICES
3401-00
3542-00
WOODLANDHIL
SEATTLE
CA
WA
91367
98124
HEALTHSCOPE BENEFITS
HEALTHSMART BENEFIT SOLUTIONS
HEALTHSMART BENEFIT SOLUTIONS
HEALTHSPRING LIFE AND HEALTH
HEALTHSPRING OF ALABAMA
3103-00
3679-00
4097-00
H216-50
3288-00
DALLAS
LUBBOCK
CHATTANOOGA
HOUTON
BIRMINGHAM
TX
TX
TN
TX
AL
75261
79453
37422
77252
35243
HEALTHSPRING OF ILLINOIS
HEALTHTEC DYNAMIC
HEART OF AMERICA TRUST
HEARTLAND NATIONAL
HELLER ASSOCIATES
H141-50
1033-00
1467-00
3881-00
2989-00
ROSEMONT
INDIANAPOLIS
OMAHA
SALT LAKE CITY
COSTA MESA
IL
IN
NE
UT
CA
60018
46268
68164
84110
92626
HENDRIX MANUFACTURING CO.INC.EMPLOYEE BENEFIT PLAN
HERITAGE CONSULTANTS INC
HERITAGE INSURANCE MANAGERS
HERITAGE LIFE INS. CO.
HERMITAGE HEALTH & LIFE INS. CO.
HERTZ CLAIM MANAGEMENT
HEWITT, COLEMAN & ASSOCIATES, INC.
HIGHLANDS INSURANCE CO
HIGHMARK DELAWARE
HIGHMARK FREEDOM BLUE
HIGHMARK SERVICES COMPANY
HIGMAN TOWING COMPANY
HILB, ROGAL, AND HAMILTON ADMINISTRATORS
HILL BROTHERS CONSTRUCTION (SELF INSURED)
HILL COUNTRY LIFE INS. CO. OF TX
HILL RICHARDS OF LA
HILLCREST BENEFITS
HILLENBRAND INDUSTRIES (SELF-INSURED)
HILLHAVEN CORP
2340-00
3107-00
1596-00
0216-00
0217-00
2445-00
0509-00
1741-00
4012-00
H979-30
3072-00
2079-00
2381-00
3121-00
0218-00
0782-00
3294-00
2058-00
1346-00
MANSFIELD
AUBURNDALE
SAN ANTONIO
AGOURA HILLS
BRENTWOOD
OKLAHOMA CITY
GREENVILLE
HOUSTON
BATON ROUGE
CAMP HILL
PITTSBURGH
ORANGE
SAVANNAH
FALKNER
AUSTIN
BATON ROUGE
MT DORA
BATESVILLE
TACOMA
LA
FL
TX
CA
TN
OK
SC
TX
LA
PA
PA
TX
GA
MS
TX
LA
FL
IN
WA
71052
33823
78217
91301
37027
73124
29608
77002
70898
17089
15253
77630
31412
38629
78766
70898
32756
47006
98401
HILLHOUSE ASSOCIATE
HILLS PET NUTRITION CO.
HILTON GROUP PLAN (SELF INSURED)
1821-00
2467-00
1360-00
AUSTIN
TOPEKA
NEW ORLEANS
TX
KS
LA
78720
66601
70140
HIP, HEALTH PLAN OF NEW YORK
HM CARE ADVANTAGE
HMO LOUISIANA,INC
HMO OF OKLAHOMA
HMO TEXAS
3688-00
3799-00
1021-00
1302-00
2815-00
25 BROADWAY
9TH FLOOR
P O BOX 2909
LOOP STATION
P O BOX 8738
3319 WEST END AVE
SUITE 900
21271 BURBANK BLVD
ELECT. CLAIMS PAYOR 59140
P O BOX 24146
P O BOX 619055
P O BOX 53010
P O BOX 188061
P O BOX 2888
2 PERIMETER PARK SOUTH
SUITE 300 WEST
9701 W HIGGINS RD/STE 360
9101 WESLEYN RD
11422 MIRACLE HILLS DR
P O BOX 2878
2755 BRISTOL
SUITE 250
P O BOX 919
P O BOX 1730
P O BOX 17339
30851 WEST AGOURA ROAD
POST OFFICE BOX 271
P O BOX 24110
POST OFFICE BOX 3808
600 JEFFERSON ST
P O BOX 98029
P O BOX 890170
P O BOX 535078
P O BOX 908
P O BOX 9888
P O BOX 131
POST OFFICE BOX 10047
P O BOX 80297
P O BOX 1516
HIGHWAY 46
BENEFITS DEPT
CALLER SERV 2264
POST OFFICE BOX 203010
P O BOX 148
NEW ORLEANS HILTON
#2 POYDRAS
55 WATER STREET
P O BOX 519
P O BOX 98024
8181 SOUTH LEWIS AVE
P O BOX 42416
NEW YORK
FORT MILL
BATON ROUGE
TULSA
HOUSTON
NY
SC
LA
OK
TX
10041
29716
70898
74137
77024
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
42
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
HODGES & FAY INS. CO.
HOLDEN & COMPANY INC
HOLIDAY LIFE INS. CO.
HOLIDOME-HOLIDAY INN CENTRAL
HOME CENTERS EMPLOYEES BENEFITS TRUST
HOME DEPOT MEDICAL BENEFITS
1954-00
3160-00
0219-00
0799-00
1169-00
2310-00
EUNICE
SAVANNAH
NORTHBROOK
LAFAYETTE
ALEXANDRIA
FAIRLAWN
LA
GA
IL
LA
LA
NJ
70535
31412
60062
70509
71301
07410
HOME INSURANCE COMPANY
HOME LIFE INS. CO.
1352-00
0220-00
METAIRIE
NEWARK
LA
NJ
70002
07192
HOME PROTECTOR
HOME TOWN HEALTH
HOMELAND HEALTHCARE
HOOD INDUSTRIES INSURANCE
HORACE MANN LIFE INS. CO.
HORIZON BCBSNJ
HORIZON HEALTH CARE EMPLOYEE BENEFIT
HORSEMAN'S BENEVOLENT PROTECTION AGENCY
HORSESHOE CASINO (SELF-INSURED)
HOSPITAL BENEFITS INC
HOSPITAL SERVICES OF LOUISIANA
HOTEL EMPLOYEES & RESTAURANT EMPLOYEES
HOUSING AUTH.OF LAFAYETTE HEALTH BENEFIT PROGRAM
1215-00
2999-00
3935-00
1899-00
0221-00
3983-00
2662-00
0768-00
2812-00
1159-00
0802-00
2498-00
2237-00
ALEXANDRIA
RENO
IRVING
HATTIESBURG
SPRINGFIELD
NEWARK
ALBUQUERQUE
NEW ORLEANS
BOSSIER CITY
JACKSON
BATON ROUGE
LAS VEGAS
NEW IBERIA
LA
NV
TX
MS
IL
NJ
NM
LA
LA
MS
LA
NV
LA
71301
89512
75039
38402
62715
07101
87190
70119
71111
39236
70898
89104
70562
HOUSING BENEFITS PLAN
HOUSTON GENERAL INSURANCE CO
HOUSTON INDUSTRIES
2793-00
1085-00
2415-00
DALLAS
FORT WORTH
HOUSTON
TX
TX
TX
75354
76113
77027
HOWARD TRUCKING COMPANY
HTH WORLWIDE
HUDSON FOOD EMPLOYEE BENEFIT PLAN
HUGHES AIRCRAFT CO. CLAIMS OFFICE
HUMANA
HUMANA
HUMANA
HUMANA
HUMANA CHOICE
HUMANA CLAIMS
HUMANA CLAIMS (PFFS)
HUMANA DENTAL
HUMANA GOLD PLUS
HUMANA HEALTH BENEFIT OF LA
HUMANA HEALTH INS CO OF FLORIDA INC
HUMANA HEALTH PLAN INC
HUMANA HEALTH PLANS
HUMANA MILITARY
HUNT PLYWOOD CO. INC (SELF INSURED)
HUVAL GROUP PROGRAM
HYDE INSURANCE AGENCY
I P A APPLE PLAN
I.B.U. NATIONAL HEALTH BENEFIT PLAN
1383-00
3826-00
2831-00
0961-00
3778-00
3738-00
3563-00
3716-00
H990-90
3628-00
H190-60
3948-00
H195-10
3997-00
2053-00
H140-60
0770-00
3624-00
1553-00
1378-00
0864-00
1269-00
1897-00
P O BOX 348
P O BOX 9360
707 COMBINED CENTRE
P O BOX 91807
P O BOX 1110
1717 RT. 208
DEPT HD
3510 N CAUSEWAY BLVD
MET OPERATIONS
P O BOX 15244
3400 MACARTHUR DRIVE
240 S ROCK BLVD
909 LAKE CAROLYN PKWY ST
P O BOX 17317
1 HORACE MANN PLAZA
P O BOX 1219
P O BOX 30668
1535 GENTILLY
711 HORSESHOE BLVD
P O BOX 16989
P O BOX 14804
1933 LAS VEGAS BLVD SO.
(SELF-INSURED)
P O BOX 14338
P O BOX 542814
P O BOX 2932
4300 POST OAK PARKWAY
5 POST OAK BLDG
113 N JEFFERSON
120 5TH AVE
P O BOX 230
P O BOX 11000
P O BOX 14604
P O BOX 14601
500 WEST MAIN STREET
P O BOX 14635
P O BOX 14610
P O BOX 14610
P O BOX 14601
P O BOX 14611
P O BOX 98
P O BOX 648
P O BOX 19080-F
P O BOX 14610
P O BOX 14610
P O BOX 7031
RT 1 BOX 15X
P O BOX 1180
1991 CORPORATE AVE
P O BOX 97
P O BOX 12245
ABBEVILLE
PITTSBURGH
HOPE
ORANGE
LEXINGTON
LEXINGTON
LOUISVILLE
LEXINGTON
LEXINGOTN
LEXINGTON
LEXINGTON
LEXINGTON
METAIRIE
CARL STREAM
JACKSONVILLE
LEXINGTON
LEXINGTON
CANIDEN
POLLACK
BREAUX BRIDGE
MEMPHIS
MEMPHIS
PORTLAND
LA
PA
AR
CA
KY
KY
KY
KY
KY
KY
KY
KY
LA
IL
FL
KY
KY
SC
LA
LA
TN
TN
OR
70510
15222
71801
92668
40512
40512
40202
40512
40512
40512
40512
40512
70004
60132
32245
40512
40512
29020
71461
70517
38132
38101
97212
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
43
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
I.G.A. GROUP EMPLOYEE BENEFIT PROGRAM
0965-00
CHICAGO
IL
60631
I.M.A.
I.U.O.E.& PIPE LINE EMPLOYERS HLTH & WELFARE FUND
I-MAD-LA
IBA HEALTH & LIFE ASSURANCE COMPANY
IBERIA SUGAR COOPERATIVE,INC
IBERVILLE OPERATING COMPANY
1335-00
1582-00
3330-00
2269-00
1022-00
1681-00
PINEVILLE
NEW ORLEANS
BOSSIER CITY
KALAMAZOO
NEW IBERIA
NEW ORLEANS
LA
LA
KY
MI
LA
LA
71361
70126
71171
49007
70561
70130
IBEW LOCAL 136 HEALTH & WELFARE FUND
IBEW LOCAL 861(HEALTH & WELFARE ELEC WORKERS)
IBEW-NECA SOUTHWESTERN HEALTH & BENEFIT FUND
ICI AMERICAS INC
ICON BENEFIT ADMINISTRATORS
IDEAL LIFE INSURANCE COMPANY
IDS LIFE INS. CO.
IEHP (INLAND EMPIRE HEALTH PLAN)
1648-00
1306-00
2861-00
2754-00
3467-00
3774-00
0222-00
4011-00
BIRMINGHAM
LAKE CHARLES
DALLAS
BOCA RATON
IRVING
CLEARWATER
MINNEAPOLIS
RANCHO CUCAMONGO
AL
LA
TX
FL
TX
FL
MN
CA
35209
70611
75244
33427
75016
33757
55402
91730
IL WU PMA WELFARE PLAN (COASTWISE)
ILA PENSION AND WELFARE FUND
ILLINOIS CENTRAL GULF HOSPITAL ASSOCIATION
ILLINOIS MUTUAL
IMAY LA INC
IMCO SERVICES
3822-00
2438-00
0806-00
0843-00
3361-00
1005-00
SAN FRANCISCO
NEW ORLEANS
HOMEWOOD
PEORIA
BOSSIER CITY
HOUSTON
CA
LA
IL
IL
LA
TX
94103
70125
60430
61634
71171
77027
IMERICA LIFE AND HEALTH INSURANCE
IMMIGRATION AND CUSTOMS INSURANCE
IMPERIAL CALCASIEU HEALTH CARE ALLIANCE
IMPERIAL FIRE INSURANCE
IMPERIAL PALACE-NPP
3769-00
3202-00
2918-00
2475-00
2853-00
GARDEN CITY
AUSTIN
LAKE CHARLES
OPELOUSAS
LAS VEGAS
NY
TX
LA
LA
NV
11530
78714
70602
70570
89193
INA LIFE INS. CO.
INC HEALTH SOLUTIONS
INDEMNITY USA
INDEPENDENCE ADMINISTRATOR
INDEPENDENCE ADMINISTRATORS/IBXTPA
INDEPENDENCE LIFE & ACCIDENT INS. CO.
INDEPENDENT ADMINISTR
INDEPENDENT BENEFITS PLAN
INDEPENDENT GROCERS ASSOCIATION
0223-00
3841-00
2390-00
3665-00
4005-00
0226-00
1211-00
1637-00
2074-00
PHILADELPHIA
EGAN
HOUSTON
HORSHAM
EAGAN
LOUISVILLE
MINNETONKA
PERU
ORLAND PARK
PA
MN
TX
PA
MN
KY
MN
IN
IL
19101
55121
77252
19044
55121
40201
55343
46970
60462
INDEPENDENT HEALTH
INDEPENDENT LIBERTY LIFE INS. CO.
INDEPENDENT LIFE AND ACCIDENT INS. CO., THE
INDESC OF EBAS CO
INDIANA FUNERAL INSURANCE TRUST
INDIANA/KENTUCKY/OHIO REG. COUNCIL
2612-00
0227-00
0228-00
1800-00
2912-00
4007-00
BUFFALO
GRAND RAPIDS
JACKSONVILLE
LYNDHURST
INDIANAPOLIS
INDIANAPOLIS
NY
MI
FL
NJ
IN
IN
14221
49502
32276
07071
46260
46242
INDIANAPOLIS LIFE INS. CO.
INDREX/QUARLES EMPLOYEES HEALTH BENEFIT PLAN
0229-00
1710-00
8725 WEST HIGGINS RD
43 ORLAND SQ, #303 ORLAND
P O BOX 4150
7370 CHEF MENTEUR HWY
P O BOX 71120
458 W SOUTH ST
PO BOX 1389
111 RUE IBERVILLE
SUITE 400
85 BAGBY DR STE 216
611 E BROAD ST
4040 MCEWEN/STE 100
P O BOX 273940
P O BOX 167768
P O BOX 10859
IDS TOWER
10801 SIXTH ST
STE 120
814 MISSION ST
2706 S CLAIBORNE AVE
2024 HICKORY RD
300 S W ADAM STREET
P O BOX 71120
248 WEST LOOP SOUTH
P O BOX 22605
100 GARDEN CITY PLAZA
P O BOX 149058
P O BOX 1393
P O BOX 422
P O BOX 97979
HUMAN RESOURCE DEPT
1600 ARCH STREET
P O BOX 21456
P O BOX 2465
P O BOX 1010
P O BOX 21974
POST OFFICE BOX 1247
10801 WAYZATA BLVD
P O BOX 1149
43 ORLAND SQUARE DR
STE 303
511 FARBER LAKES DR
126 OTTAWA AVENUE, N.W.
ONE INDEPENDENT DRIVE
160 CHUBB AVE
1311 WEST 96TH
CARPENTERS WELFARE FUND
P O BOX 421729
POST OFFICE BOX 1230B
7633 E 63RD PLACE
STE 500
INDIANAPOLIS
TULSA
IN
OK
46206
47133
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
44
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
INDUSTRIAL ELECTRONIC SUPPLIES INC
2093-00
SHREVEPORT
LA
71105
INDUSTRIAL LIFE INS. CO.
INDUSTRIAL TECHNICAL & PROFESSIONAL EMPLOYEES GROUP
INGRAM INDUSTRIES INS CO
INHEALTH INC
0230-00
1877-00
2166-00
2570-00
DALLAS
SAVANNAH
NASHVILLE
WORTHINGTON
TX
GA
TN
OH
75222
31403
37202
43235
INLAND EMPIRE HEALTH PLAN
INSEARCH COMPANY
3827-00
1344-00
SAN BERNADINO
HOUSTON
CA
TX
92423
77210
INSIGNIA FINANCIAL GROUP INC
INSPECTION SERVICES INC (SELF-INSURED)
INSTASERVE SYSTEMS INC
INSULATORS LOCAL UNION NO. 112
INSURANCE ADMINISTRATOR OF AMERICA
INSURANCE AND RISK MANAGEMENT
INSURANCE BENEFIT SERVICE
INSURANCE CLAIM SERVICE
INSURANCE COMPANY OF NORTH AMERICA
INSURANCE COMPANY OF SCOTT
INSURANCE DATA ADMINISTRATORS
2249-00
2144-00
1333-00
1828-00
3170-00
1816-00
0792-00
2224-00
0854-00
4030-00
0859-00
GREENVILLE
AMELIA
DELAWARE
LAKE CHARLES
MT LAUREL
MIAMI BEACH
HOUSTON
BIRMINGHAM
PHILADELPHIA
TEMPLE
SANTA ANNA
SC
LA
OH
LA
NJ
FL
TX
AL
PA
TX
CA
29602
70340
43015
70601
08054
33141
77218
35243
19101
76502
95401
INSURANCE
INSURANCE
INSURANCE
INSURANCE
INSURANCE
INSURANCE
2182-00
3750-00
1428-00
2164-00
1577-00
1855-00
MEDICAL BENEFIT PLAN
3776 YOUREE DR
POST OFFICE BOX 220998
P O BOX 23679
P O BOX 23049
200 EAST CAMPUS VIEW BLVD
SUITE 300
P O BOX 10129
CLAIMS PROCESSING
P O BOX 4271
BOX 1089
P O BOX 1289
P O BOX 1005
512 CLARENCE STREET
P O BOX 5082
P O BOX 41-4043
P O BOX 218969
P O BOX 43350
1600 ARCH ST
1206 WEST CAMPUS DR
1400 N DUTTON AVE
SUITE 15
P O BOX 875
P O BOX 2806
P O BOX 71120
P O BOX 15688
P O BOX 4705
11330 IH 10 WEST
SUITE 2100
BOX 2175
P O BOX 90802
P O BOX 12830
P O BOX 998
P O BOX 15953
P O BOX 65887
230 W PRIEN LAKE
P O BOX 619070
P O BOX 39119
P O BOX 21456
P O BOX 21456
P O BOX 41779
645 PLAZA WEST BUILDING
P O BOX 94785
EMPLOYERS/HEALTH-WELFARE
4151 CHEASAPEAKE ST NW
420 N. SPRUCE STREET
10065 RED RUN BLVD
75 TECHNOLOGY DRIVE
MACK CENTRE DRIVE
5445 LA DIERRA DR
SUITE 400
OAKLAND
CLINTON
BOSSIER CITY
AMARILLO
MONROE
SAN ANTONIO
NJ
IA
LA
TX
LA
TX
07436
52733
71171
79105
71203
78249
MONROE
LUBBOCK
JACKSON
JAMESVILLE
LUBBOCK
WEST DES MOINES
LAKE CHARLES
DFW AIRPORT
PHOENIX
EAGAN
EAGAN
MEMPHIS
LITTLE ROCK
CLEVELAND
WASHINGTON
LA
TX
MS
WI
TX
IA
LA
TX
AZ
MN
MN
TN
AR
OH
DC
71207
79408
39211
53547
79790
50265
70601
75261
85069
55121
55121
38174
72205
44101
20016
WINSTON-SALEM
OWINGS MILLS
LOWELL
PARAMUS
DALLAS
NC
MD
MA
NJ
TX
27101
21117
01851
07652
75231
DESIGN ADMINISTRATORS
HEALTH
MANAGEMENT ADMINISTRATION
MANAGEMENT SERVICES
RESOURCES MANAGEMENT INC
SERVICE CENTER (CARE)
INSURANCE SYSTEMS CLAIMS
INSURANCE SYSTEMS INC
INSURANCE SYSTEMS INC
INSURANCE TPA
INSURANCE TPA
INSURANCE TRUST
INSURANCE UNLIMITED
INSURDATA INCORPORATED
INSURERS ADMINISTRATIVE CORP
INSURERS ADMINISTRATORS
INSURERS ADMINISTRATORS
INSUREX BENEFITS ADMINISTRATORS INC
INSURNATIONAL INCORPORATED INSURANCE CO.
INSURX
INT'L UNION OF OPERATING ENGINEERS & PIPE LINE
1941-00
3856-00
0818-00
3918-00
3917-00
2137-00
2572-00
1656-00
1570-00
0666-00
3666-00
2697-00
1020-00
2128-00
1700-00
INTEGON LIFE INS. CORP.
INTEGRATED HEALTH SERVICES
INTEGRATED RESOURCES LIFE INS. CO.
INTEGRITY LIFE INS. CO.
INTEQ
0231-00
2647-00
1810-00
0232-00
3186-00
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
45
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
INTER AMERICAN INSURANCE CORP
INTER COUNTY HOSPITALIZATION
INTER VALLEY HEALTH PLAN
3088-00
2615-00
3839-00
WICHITA
HORSHAM
POMANA
KS
PA
CA
67277
19044
91769
INTER-CORP.(SCHUMPERT MEDICAL CENTER)
INTER-OCEAN INS. CO.
INTER-STATE ASSURANCE CO., A MUTUAL CO.
INTERACTIVE MEDICAL SYSTEMS
INTERCARE
INTERCONTINENTAL LIFE INS. CO.
INTERGROUP
0973-00
0234-00
0235-00
2523-00
2120-00
0233-00
2102-00
HOUSTON
CINCINNATI
DES MOINES
RALEIGH
ENGLEWOOD
ELIZABETH
TUCSON
TX
OH
IA
NC
CO
NJ
AZ
77023
45214
50306
27619
80155
07208
85710
INTERNAT'L UNION & INDUSTRY HEALTH AND BENEFIT FUND
INTERNATIONAL ASSOC OF BENEFITS
INTERNATIONAL BENEFITS
INTERNATIONAL BENEFITS SERVICES CORPORATION
INTERNATIONAL BROTHERHOOD OF ELECTRICAL WORK.
2112-00
3597-00
3929-00
1831-00
0906-00
BIRMINGHAM
WASHINGTON
GARDEN CITY
FORT WORTH
ALEXANDRIA
AL
DC
NY
TX
LA
35255
20006
11530
76101
71301
INTERNATIONAL BROTHERHOOD OF PAINTERS & ALLIED TRADE
2113-00
NEW ORLEANS
LA
70127
INTERNATIONAL CLAIMS SERVICES LTD
INTERNATIONAL INCORPORATED
INTERNATIONAL LONGSHOREMEN'S ASS'N
1541-00
2259-00
1173-00
ATLANTA
LITTLE ROCK
NEW ORLEANS
GA
AR
LA
30340
72203
70130
INTERNATIONAL LONGSHOREMENS ASSN
INTERNATIONAL MEDICAL GROUP
INTERNATIONAL MEDICAL GROUP
INTERNATIONAL MINERALS AND CHEMICALS CORP
INTERNATIONAL OPERATORS UNION ENGINEERS(IOUE)
INTERSTATE BRANDS CORP.
INTRACORP
INTRNATIONAL CATERING ENTERPRISES
3920-00
3975-00
3355-00
0772-00
0889-00
2304-00
2689-00
1757-00
PORT ALLEN
INDIANAPOLIS
INDIANAPOLIS
STERLING
NEW ORLEANS
OMAHA
BELLE CHASSE
SEATTLE
LA
IN
IN
LA
LA
NE
LA
WA
70767
46208
46208
71280
70126
68175
70037
98104
INVERSION IND.INC MED BENEFIT PLAN-THE HEALTH CARD
INVESTOR LIFE GROUP INC.
INVESTORS DIVERSIFIED INSURANCE CORP
INVESTORS GUARANTY LIFE INS. CO.
INVESTORS HERITAGE LIFE INS. CO.
IOWA BEEF PROCESSORS INC
IPMG
IRON WORKERS HEALTH & WELFARE PLAN
IRON WORKERS HOSPITAL PLAN
IRON WORKERS LOCAL 40,361 & 417 UNION SECURITY FUND
IRON WORKERS LOCAL 58 WELFARE PLAN
2750-00
1112-00
1242-00
0236-00
0237-00
2253-00
3939-00
1607-00
1686-00
1533-00
1048-00
MT.CLEMONS
CHATTANOOGA
BATON ROUGE
MERCER ISLAND
FRANKFORT
MADISON
ST CHARLES
NEW ORLEANS
PHILADELPHIA
NEW YORK
METAIRIE
MI
TN
LA
WA
KY
NE
IL
LA
PA
NY
LA
48046
37405
70895
98040
40601
68748
60174
70116
19149
10016
70001
IRON WORKERS WELFARE FUND
IRON WORKERS WELFARE FUND
IRONWORKERS WELFARE PLAN
ISPAT
ITPE-NMU HEALTH & WELFARE FUND
ITS, INC (INTERNATIONAL TOTAL SERVICES)
3649-00
2609-00
0913-00
3251-00
1119-00
2966-00
P O BOX 9510
720 BLAIR MILL RD
300 S PARK AVE
P O BOX 6002
2002 SOUTH WAYSIDE
POST OFFICE BOX 14568
POST OFFICE BOX 1907
P O BOX 19108
P O BOX 3559
40 PARKER ROAD
1010 N FINANCE CENTER DR
STE 100
P O BOX 55728
174 PENNSYLVANIA AVE N W
PO BOX 9306
P O BOX 1326
LOCAL 576
PO BOX 5543
LOCAL UNION 728
10054 I10 SERVICES RD, E
3855 PRESIDENTIAL PARK
P O BOX 8061
AF OF L - CIO
2337 TCHOUPITOULAS ST
P O BOX 197
P O BOX 88500
2960 N MERIDIAN ST
P O BOX 626
7370 CHEF MENTEUR HWY
MUTUAL OF OMAHA PLAZA
P O BOX 237
800 5TH AVE
SUITE 3420
P O BOX 2305
25 CHEROKEE BLVD
P O BOX 45597
3003 77TH AVENUE, S.E.
POST OFFICE BOX 717
P O BOX 1010
225 SMITH RD
1407 DECATUR ST
6401 CASTOR AVE
451 PARK AVE SOUTH
4200 I-10 SERVICE RD WEST
STE 134
2450 SEVERN AVE #305
1470 WORLDWIDE PL
PO BOX 4617
3201 WATLING
P O BOX 23679
5005 ROCKSIDE RD
METAIRIE
VANDALIA
MONROE
EAST CHICAGO
SAVANNAH
CLEVELAND
LA
OH
LA
IN
GA
OH
70001
45377
71211
45312
31403
44131
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
46
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
ITT HARTFORD INSURANCE
2022-00
WOODBRIDGE
NJ
07095
ITT LIFE INS. CORP.
0224-00
MINNEAPOLIS
MN
55426
ITT LYNDON LIFE INS. CO.
IVAN SMITH FURNITURE EMPLOYEE BENEFIT TRUST
J C PENNEY LIFE INS CO/STONEBRIDGE LIFE INS CO
J H WALKER, INC BENEFIT PLAN
J P PARLEY CORPORATION
J P S HEALTH NETWORK
J R H RISK SERVICES
J W TERRILL BENEFIT ADMINISTRATORS
J.E. MERIT CONSTRUCTORS
J.W.CURELL NORTH AMERICAN ADMINISTRATORS
JACK A. PARKER & ASSOC. INC.
JACK DANIEL MEDICAL EXPENSE BENEFIT PLAN
JACK ECKERD CORPORATION CLAIMS DEPARTMENT
JACKSON KEARNEY GROUP
JACKSON LONG AND ASSOCIATES
JAMES BENEFITS - GREYHOUND CLAIMS
JAMES BENEFITS-SIDA/SWA BENEFIT TRUST FUND
JARDINE GROUP SERVICES
JEFF DAVIS HOSPITAL EMPLOYEE BENEFITS
JEFFERSON LIFE INSURANCE COMPANY
0225-00
3297-00
0238-00
3097-00
3285-00
3478-00
1248-00
3437-00
1693-00
2124-00
0527-00
2560-00
1735-00
2422-00
1136-00
0978-00
0781-00
2995-00
0962-00
2083-00
ST. LOUIS
SHREVEPORT
PLANO
HOUSTON
WESTLAKE
FT WORTH
BIRMINGHAM
CHESTERFIELD
BATON ROUGE
NASHVILLE
NEW ORLEANS
LYNCHBURG
CLEARWATER
NEW ORLEANS
OLYMPIA FIELDS
TEMPE
ATLANTA
SCHUNECTADY
NATCHEZ
DALLAS
MO
LA
TX
TX
OH
TX
AL
MO
LA
TN
LA
TN
FL
LA
IL
AZ
GA
NY
MS
TX
63131
71137
75086
77224
44145
76104
35236
63006
70898
37202
70190
37352
34618
70153
60461
85282
30303
12301
39120
75243
JEFFERSON NATIONAL LIFE INS. CO.
0239-00
INDIANAPOLIS
IN
46204
JEFFERSON PARISH SHERIFF OFFICE
JEFFERSON PILOT
JEFFERSON PILOT
JEFFERSON PILOT INSURANCE CO
JEFFERSON SERVICE CO. INC
JELD-WEN HEALTH BENEFIT PLAN
JELDWEN
JENMAR INDUSTRIES
JIMMY SWAGGART MINISTRIES (SELF-INSURED)
JOBMATE LEASED EMPLOYEES TRUST
JOHN ALDEN LIFE INSURANCE COMPANY
JOHN DEERE DEALER GROUP INS CO
JOHN DEERE LIFE INS. CO.
JOHN E. CHANCE & ASSOCIATES
JOHN HANCOCK MUTUAL LIFE INS. CO.
JOHN HANDCOCK INS CO
1185-00
1180-01
1151-00
1180-00
1891-00
2721-00
3335-00
2115-00
1494-00
1102-00
0240-00
1123-00
0241-00
1690-00
0242-00
2236-00
METAIRIE
GREENSBORO
GREENSBORO
GREENSBORO
SHREVEPORT
BEND
REDMOND
WINNSBORO
BATON ROUGE
RIDGELAND
BOISE
MOLINE
JACKSONVILLE
SHREVEPORT
BOSTON
COLUMBUS
LA
NC
NC
NC
LA
OR
OR
LA
LA
MS
ID
IL
IL
LA
MA
OH
70001
27420
27420
27420
71135
97708
97756
71295
70821
39158
83701
61265
62651
71135
02117
43085
JOHN HOPKINS HEALTH CARE
JOHN LLOYD THOMPSON SERVICES
JOHN MANVILLE
3154-00
3086-00
1051-00
GLEN BURNIE
SCHENECTADY
PORTLAND
MD
NY
OR
21060
12301
97205
JOHN O FELKER BENEFIT SERVICES
1385-00
ST LOUIS
MO
63102
JOHNSON ADMINISTRATORS
1580-00
NJ HEALTH CLAIM OFFICE
90 WOODBRIDGE CENTER
SHELARD TOWER, STE. 600
600 S. COUNTY ROAD 18
12555 MANCHESTER ROAD
P O BOX 70100
P O BOX 869091
P O BOX 19771
P O BOX 458022
1500 S MAIN ST
P O BOX 36697
P O BOX 989
P O BOX 80257
P O BOX 1984
POST OFFICE BOX 30180
P O BOX 199
P O BOX 8210
P O BOX 53235
20000 GOVERNORS DRIVE
P O BOX 22777
235 PEACH ST NE
P O BOX 2209
PO BOX 1488
9304 FOREST LANE NORTH
STE 256
JEFFERSON BUILDING
ONE VIRGINIA AVENUE
3300 METAIRIE ROAD
P O BOX 20727
P O BOX 20727
P O BOX 21008
P O BOX 51005
P O BOX 5128
P O BOX 1747
RT 1 BOX 33
P O BOX 2550
P O BOX 213
P O BOX 1599
P O BOX 620
110 NORTH EAST STREET
POST OFFICE BOX 51005
POST OFFICE BOX 111
300 EAST WILSON BRIDGE RD
SUITE 255
6704 CURTIS COURT
P O BOX 2209
SUITE 440
720 S WASHINGTON ST
P O BOX 8895
JEFFERSON MEMORIAL STATIO
P O BOX 248
NEWTOWN
PA
18940
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
47
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
JONES,HILLS & MERCER EMPLOYEE BENEFITS,INC
JOURNEY HOSPICE
JSL ADMINISTRATORS
JUSTISS OIL COMPANY INC
JV INDUSTRIAL COMPANIES
K & B PRESCRIPTION PLANS
K & K SPECIALTY BENEFITS INC
K C I EMPLOYEE BENEFIT TRUST
K-MART COMPREHENSIVE CARE
KAISER FOUNDATION
KAISER FOUNDATION HEALTH PLAN
1298-00
4100-00
3234-00
1940-00
3242-00
2707-00
3236-00
2824-00
2816-00
H086-00
0766-00
SAVANNAH
ALEXANDRIA
FAYETTEVILLE
SHREVEPORT
MONROE
NEW ORLEANS
FORT WAYNE
SAN ANTONIO
TAMPA
OAKLAND
OAKLAND
GA
LA
NC
LA
LA
LA
IN
TX
FL
CA
CA
31412
71303
28302
71135
71207
70130
46801
76265
30588
94604
94604
KAISER PERMANENTE
KAISER PERMANENTE
KAISER PERMANENTE HMO
3748-00
H052-40
1796-00
ATLANTA
OAKLAND
PORTLAND
GA
CA
OR
31119
94604
97210
KANAWHA
KANSAS CITY LIFE INS. CO.
KARE CHOICE - CIRCLE K CORP - SELF INSURED
1748-00
0243-00
1437-00
LANCASTER
KANSAS CITY
DES MOINES
SC
MO
IA
29721
64141
50306
KAROON AND BLACK
KAST METAL EMPLOYEE BENEFIT TRUST
KELLY ASSOCIATES
1347-00
0701-00
0952-00
GREENVILLE
SHREVEPORT
METAIRIE
MS
LA
LA
38701
71136
70001
KELSEYCARE ADVANTAGE
KELSEYCARE ADVANTAGE
KEMPER GROUP
KENNESAW LIFE AND ACCIDENT INS. CO.
KENTUCKY CENTRAL LIFE INS. CO.
KENTUCKY HOME MUTUAL LIFE INS. CO.
KEPPLE AND COMPANY INC
KERR-MCGEE CORPORATION
KEY BENEFIT ADMIN
KEY BENEFIT ADMINISTRATORS
KEYSTONE LIFE INS. CO.
KILPATRIC LIFE INS. CO. OF LA
KIMBERLY-CLARK CORPORATION
KINDER HOSPITAL LAFAYETTE
KINKO'S
KIRBY HEALTH CARE PLAN
KIRKE-VAN ORSDEL
KITSAP PHYSICIAN SERVICE
KLAIS & COMPANY
KLEIN TOOL INSURANCE CO
KLLM EMPLOYEE BENEFITS PLAN
KMSB (KLAMATH MEDICAL SERVICES BUREAU)
KNIGHTS AND DAUGHTERS OF TABOR
KNIGHTS OF COLOMBUS HEALTH & ACCIDENT DIV.
KOCH SERVICES (SELF INSURED)
KOHLER CO. EMPLOYEE BENEFITS INSURANCE
KRISPY KREME HEALTH CARE PLAN (SELF-INSURED)
H049-00
3963-00
1753-00
0244-00
0245-00
0246-00
2694-00
0857-00
4059-00
2619-00
0247-00
0248-00
2103-00
3941-00
2666-00
2661-00
0899-00
3102-00
3891-00
0934-00
3554-00
2849-00
0975-00
1775-00
1114-00
1923-00
1453-00
P O BOX 9888
221 PECAN PARK/STE C & D
P O BOX 2857
P O BOX 51005
P O BOX 2175
K & B PLAZA LEE CIRCLE
P O BOX 2338
P O BOX 590450
P O BOX 30588
P O BOX 12916
REGIONAL CLAIMS
P O BOX 12923
P O BOX 190849
P O BOX 12923
2701 NORTHWEST VAUGHN
SUITE 300
P O BOX 2000
POST OFFICE BOX 139
400 LOCUST ST
P O BOX 9122
P O BOX 1796
P O DRAWER 6611-M
4200 S I-10 SVS RD WEST
SUITE 134
P O BOX 300427
P O BOX 300427
P O BOX 870730
POST OFFICE BOX 7580
KINCAID TOWERS
5TH AND JEFFERSON STREETS
P O BOX 1986
KERR-MCGEE CENTER
P O BOX 1279
P O BOX 55210
POST OFFICE BOX 809027
1818 MARSHALL STREET
P O BOX 29800
204 ENERGY PKWY
P O BOX 55016
P O BOX 833835
777 THIRD ST
P O BOX 339
1867 W MARKET ST
7200 MC CORMICK RD
P O DRAWER 1400
P O BOX 5016
P O BOX 849
P O BOX 3477
P O BOX 2256
P O BOX 1709
P O BOX 53
HOUSTON
HOUSTON
NEW ORLEANS
ATLANTA
LEXINGTON
LOUISVILLE
PEORIA
OKLAHOMA CITY
FORT MILL
INDIANAPOLIS
DALLAS
SHREVEPORT
ATLANTA
LAFAYETTE
FRESNO
RICHARDSON
DES MOINES
BREMENTON
AKRON
CHICAGO
OXFORD
KLAMATH FALLS
MOUND BAYOU
OMAHA
WICHITA
BROWNWOOD
WINSTON-SALEM
TX
TX
LA
GA
KY
KY
IL
OK
SC
IN
TX
LA
GA
LA
CA
TX
IA
WA
OH
IL
MS
OR
MS
NE
KS
TX
NC
77230
77230
70186
30357
40508
40202
61656
73125
29816
46205
75380
71101
30359
70508
93747
75083
50309
98337
44313
60645
38655
97601
38762
68172
67201
76804
27102
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
48
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
KRUEGER-RINGIER-EMPLOYEE BENEFITS
L M BERRY AND CO (SELF-INSURED)
L T V STEEL COMPANY
1889-00
1457-00
2004-00
ITASCA
DAYATON
CLEVELAND
IL
OH
OH
60143
45401
44101
L.D.BRINKMAN & CO
LA AUTO DEALERS TRUST
LA CARPENTERS REGIONAL COUNSIL
2345-00
1289-00
3631-00
DALLAS
BATON ROUGE
METAIRIE
TX
LA
LA
75356
70810
70002
LA CARPENTERS REGIONALL COUNCIL
3637-00
METAIRIE
LA
70002
LA
LA
LA
LA
LA
LA
LA
LA
LA
LA
LA
LA
LA
0505-00
1192-00
2291-00
3198-00
4044-00
2362-00
3689-00
0712-01
0712-00
0728-00
1188-00
1888-00
1747-00
ONE PIERCE PLACE
P O BOX 6000
EMPLOYEE BENEFIT SERVICES
P O BOX 94571
P O BOX 569710
7526 PICARDY AVE
3351 SEVERN AVE
STE 202
3351 SEVERN AVE
SUITE 202
POST OFFICE BOX 44036
PO BOX 246
P O BOX 246
P O BOX 7765
P O BOX 100043
6902 PEARL RD/STE 500
P O BOX 1449
1407 DECATUR ST
440 N FOSTER DR #105
P O BOX 80297
P O BOX 4266
P O BOX 2636
2800 VETERANS BLVD
STE 160
P O BOX 14338
P O BOX 98052
3831 GILBERT DRIVE
P O BOX 51005
(LHAEBT)
5220 GALAXYY
P O BOX 690465
1535 GENTILLY BLVD
P O BOX 8200
P O BOX 3137
1168 SUTTER ST
3340 SEVERN AVE/STE 225
905 16TH ST NW
10440 LITTLE PATUXENT PWY
SUITE 700
1233 GOVERNMENT ST
10000 PERKINS ROWE BK G
4TH FLR
10000 PERKINS ROWE BK G
4TH FLOOR
P O BOX 1194
315 MONROE ST
SUITE B
P O BOX 4017-C
705 WEST UNIVERSITY AV
GROUP MEDICAL PLAN
P O BOX 52009 OCS
BATON ROUGE
RACELAND
RACELAND
METAIRIE
DULUTH
CLEVELAND
GOODLETTSVILLE
NEW ORLEANS
BATON ROUGE
BATON ROUGE
SHREVEPORT
SAN ANTONIO
METAIRIE
LA
LA
LA
LA
GA
OH
TN
LA
LA
LA
LA
TX
LA
70804
70394
79394
70010
30096
44130
37070
70116
70806
70898
71104
78299
70002
NEW IBERIA
BATON ROUGE
SHREVEPORT
SHREVEPORT
JACKSON
LA
LA
LA
LA
MS
70562
70898
71104
71135
39206
SAN ANTONIO
NEW ORLEANS
BURLINGTON
SCOTTSDALE
SAN FRANCISCO
METAIRIE
WASHINGTON
COLUMBIA
TX
LA
NC
AZ
CA
LA
DC
MD
78269
70119
27215
85271
94109
70002
20006
21044
BATON ROUGE
BATON ROUGE
LA
LA
70802
70810
BATON ROUGE
LA
70810
MINNEAPOLIS
BOSSIER CITY
MN
LA
55440
71111
LAFAYETTE
LAFAYETTE
LAFAYETTE
LA
LA
LA
70502
70506
70505
EMPLOYEES STATE GROUP/OFFICE OF GROUP BENEFITS
FOURCHE LIFE INC COMPANY
FOURCHE LIFE INSURANCE CO
HEALTH CARE SELF INSURANCE
HEALTH COOPERATIVE
HELPING HANDS EMPLOYEE HEALTH PLAN VPA
LABOR HEALTH & WELFARE
LABORERS HEALTH & WELFARE PLAN
LABORERS HEALTH AND WELFARE PLAN
MUNICIPAL RISK MANAGEMENT AGENCY II
PEST CONTROL ASSOC GROUP INS TRUST
QUINTA MOTOR INNS INC
RESTAURANT ASSOCIATION
LA SAFETY SYSTEMS GROUP HEALTH PROGRAM
LA WORKER'S COMPENSATION CORP.
LA. ALLIANCE MEDICAL CORPORATION
LA. CONFERENCE METHODIST CHURCH (SELF-FUNDED)
LA. HOSPITAL ASSOC. EMPLOYEES BENEFIT TRUST
2539-00
2819-00
2826-00
1443-00
1359-00
LA. WHOLESALE GROCER'S ASSOCIATION
LA.HORSEMEN BENEVOLENT & PROTECTIVE ASSOC INC
LAB CORPS
LABORATORY CORPORATION OF AMERICA
LABORER'S HEALTH & TRUST FUND FOR N.CALIFORNIA
LABORERS HEALTH & WELFARE
LABORERS INTERNATIONAL UNION OF NORTH AMERICA
LABORERS NATIONAL HEALTH/WELFARE
0958-00
2670-00
2905-00
2911-00
1225-00
2986-00
1598-00
3953-00
LABORS LOCAL 1177
LACARE
2673-00
9999-91
LACARE INTEREST PAYMENTS
INT9-91
LAFARGE CORP. (SELF-INSURED)
LAFAYETTE CARPENTERIA LOCAL 1897 HLT & WELFARE FUND
2451-00
1111-01
LAFAYETTE CITY PARISH
LAFAYETTE CONSOLIDATED GOVERNMENT
LAFAYETTE GENERAL MEDICAL CENTER
3719-00
3823-00
1084-00
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
49
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
LAFAYETTE
LAFAYETTE
LAFAYETTE
LAFOURCHE
LAFOURCHE
0249-00
2402-00
2009-00
2363-00
2229-00
POST OFFICE BOX 7007
P O BOX 4508
P O DRAWER 2158
P O BOX 70100
LEIGHTON FACTORY
LEIGHTON RD
P O BOX 12170
P O BOX 90802
8927 W NATIONAL AVE
7777 HENNESSY BLVD
SUITE 1004-111
POST OFFICE BOX 880
P O BOX 51102
3831 GILBERT DR
6300 MAIN ST
P O BOX 11069
P O BOX 790064
POST OFFICE BOX 40913
680 CRAIG RD
SUITE 200
2500 LINE AVENUE
P O BOX 539508
2311 CEDAR SPRINGS
P O BOX 489
12222 MERIT DR
SUITE 850
GROUP CANCER CARE INS
P O BOX 1146
4534 WORNELL RD
1116 COOLIDGE BLVD
8550 UNITED PLAZA BLVD
STE 800
P O BOX 3558
P O BOX 18100
P O BOX 26110
1529 NEWTON ST
6001 FINANCIAL PLAZA
P O BOX 2817
175 BERKLEY STREET
POST OFFICE BOX 789
PO BOX 5014
P O BOX 1052
P O BOX 152067
POST OFFICE BOX 2612
2200 WALNUT STREET
AMERICAN GENERAL CENTER
222 NORTH MICHIGAN AVENUE
650 POYDRAS ST/SUITE 1900
POST OFFICE BOX 187
P O BOX 5506
P O BOX 5506
LAFAYETTE
LAFAYETTE
LAFAYETTE
SHREVEPORT
THIBODAUX
IN
LA
LA
LA
LA
47903
70502
70502
71137
70301
OVERLAND PARK
LUBBOCK
WEST ALLIS
BATON ROUGE
KS
TX
WI
LA
66212
79408
53227
70808
JACKSON
LAFAYETTE
SHREVEPORT
ZACHARY
MEMPHIS
SAN ANTONIO
INDIANAPOLIS
ST LOUIS
MS
LA
LA
LA
TN
TX
IN
MO
39205
70508
71104
70791
38111
78279
46240
63141
SHREVEPORT
GRAND PRAIRIE
DALLAS
INDEPENDENCE
DALLAS
LA
TX
TX
LA
TX
71104
75053
75201
70443
75251
SANTA BARBARA
CA
93102
KANSAS CITY
LAFAYETTE
BATON ROUGE
MO
LA
LA
64111
70501
70809
BATON ROUGE
COLUMBUS
SANTA ANA
NEW ORLEANS
SHREVEPORT
GAINESVILLE
BOSTON
GREENVILLE
FRESNO
MONTGOMERYVILLE
IRVING
BIRMINGHAM
PHILADELPHIA
NASHVILLE
CHICAGO
NEW ORLEANS
METAIRIE
SAN JOSE
SAN JOSE
LA
OH
CA
LA
LA
GA
MA
SC
CA
PA
TX
AL
PA
TN
IL
LA
LA
CA
CA
70821
43218
92799
70114
71130
30503
02117
29602
93784
18936
75015
35202
19103
37250
60601
70130
70004
95150
95150
LIFE INS. CO., THE
PARISH GOVERNMENT (SELF-INSURED)
PARISH SCHOOL BOARD EMPLOYEE INS. FUND
PARISH WATER DISTRICT #1
SUGAR CORP (SUGAR MILL-SELF INSURED)
LAHOOD & ASSOCIATES INC
LAKE CHARLES MEMORIAL-SELF FUNDED
LAKE COUNTRY DENTAL INSURANCE PLANS
LAKE PHYSICIAN HEALTH
1492-00
3378-00
2396-00
2686-00
LAMAR LIFE INS. CO.
LAMB SERVICES-TONG SPECIALTY GROUP HEALTH BENEFITS
LAMCORP
LANE MEMORIAL HOSPITAL
LANGSTON COMPANIES INC
LAQUINTA INNS (SELF-INSURED)
LAYMEN NATIONAL LIFE INS. CO.
LDI INTEGRATED PHARMACY SERVICES
0250-00
2935-00
3005-00
2403-00
2318-00
2048-00
0251-00
3883-00
LEE NATIONAL LIFE INS. CO. OF LA
LEGACY HEALTH PLAN
LEGAL SECURITY INS CO
LEGGETT & PLATT INC
LEGION INSURANCE COMPANY
0252-00
3248-00
0844-00
1762-00
3064-00
LEGIONNARE INSURANCE TRUST
2606-00
LEWER AGENCY INSURANCE
LGA HEALTH INSURANCE
LHC INTEREST PAYMENTS
2136-00
0765-00
INT9-93
LHCA/LBGH
LIBBY OWENS FORD (SELF-INSURED)
LIBERTY DENTAL PLAN
LIBERTY GROUP
LIBERTY HERITAGE LIFE INS. CO.
LIBERTY LIFE
LIBERTY LIFE ASSURANCE CO. OF BOSTON
LIBERTY LIFE INS. CO.
LIBERTY MUTUAL
LIBERTY MUTUAL
LIBERTY MUTUAL FIRE INSURANCE COMPANY
LIBERTY NATIONAL LIFE INS. CO.
LIFE & HEALTH INS. CO. OF AMERICA
LIFE AND CASUALTY INS. CO. OF TN
LIFE ASSURANCE CO. OF PA
LIFE CARE MANAGEMENT SYSTEMS INC
LIFE GENERAL SECURITY INS. CO.
LIFE GUARD INSURANCE CO
LIFE GUARD INSURANCE CO
2797-00
2678-00
3801-00
1587-00
0253-00
1161-00
0254-00
0255-00
0847-00
3714-00
1756-00
0256-00
0260-00
0258-00
0257-00
1456-00
0259-00
0017-06
1706-00
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
50
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
LIFE INS. CO. OF ALABAMA
LIFE INS. CO. OF LA
LIFE INS. CO. OF THE SOUTH
0261-00
0263-00
0265-00
GADSDEN
SHREVEPORT
COVINGTON
AL
LA
LA
35902
71166
70433
LIFE
LIFE
LIFE
LIFE
LIFE
LIFE
0266-00
0267-00
0813-00
0264-00
0268-00
1798-00
POST OFFICE BOX 349
POST OFFICE BOX 1803
ONE NORTH LAKE CORP PARK
1000 HIGHWAY 190
POST OFFICE BOX 47421
POST OFFICE BOX 27601
P O BOX 40964
P O BOX 801067
4333 EDGEWOOD RD N E
2727 ALLEN PARKWAY
WORTHAM TOWER SIXTH FLOOR
P O BOX 105022
P O BOX 70
345 N RIVER VIEW
STE 600
P O B 2503
4810 INDUSTRIAL DRIVE
P O BOX 7709
P O BOX 91060
LILLY CORPORATE CENTER
DROP CODE 2018
POST OFFICE BOX 3250
POST OFFICE BOX 80469
P O BOX 614008
P O BOX 51005
P O BOX 10843
4808 NORTH 22ND STREET
POST OFFICE BOX 81209
1300 SOUTH CLINTON STREET
BENEFITS PLAN
P O BOX 1210
POST OFFICE BOX 1173
2000 SPRINGER DRIVE
STATE MUTUAL COMPANIES
1100 W 31 ST/STE 460
5220 AIRLINE DR
15414 KATY FREEWAY
SUITE 800
P O BOX 3968
206 BEAUMONT DR
P O BOX 5543
8111 TOM DR
535 ASHBY ST SW
P O BOX 115027
2501 BELL AVEUNE
461 STATE RTE 33
2041 BEAUMONT DR
P O BOX 1002
CHOCTAW DR
3200 RIDGE LAKE DR
SUITE 207
DALLAS
RICHMOND
INDIANAPOLIS
DALLAS
CEDAR RAPIDS
HOUSTON
TX
VA
IN
TX
IA
TX
75247
23261
46240
75380
52499
77019
ATLANTA
SHREVEPORT
WICHITA
GA
LA
KS
30348
71136
67203
TYLER
NEW IBERIA
BEND
SEATTLE
INDIANAPOLIS
TX
LA
OK
WA
IN
75710
70560
97708
98111
46285
MEMPHIS
LINCOLN
ORLANDO
SHREVEPORT
CLEARWATER
PHOENIX
LINCOLN
FORT WAYNE
BREAUX BRIDGE
TN
NE
FL
LA
FL
AZ
NE
IN
LA
38103
68501
32861
71135
33757
85016
68501
46801
70557
LOUISVILLE
LOMBARD
DOWNERS GROVE
KY
IL
IL
40203
60148
60515
BOSSIER CITY
HOUSTON
LA
TX
71111
77094
BOCA RATON
BATON ROUGE
ALEXANDRIA
BATON ROUGE
ATLANTA
FL
LA
LA
LA
GA
33427
70806
71307
70808
30301
DES MOINES
MANALAPAN
BATON ROUGE
PRAIRIEVILLE
BATON ROUGE
METAIRIE
IA
NJ
LA
LA
LA
LA
50321
07726
70806
70769
70815
70072
INS. CO. OF THE SOUTHWEST
INS. CO. OF VIRGINIA
INSURANCE CO OF INDIANA
INSURANCE CO OF NORTH AMERICA
INVESTORS INS. CO. OF AMERICA
OF AMERICA INSURANCE CO
LIFE OF GEORGIA
LIFE SHAREBLOOD CENTERS
LIFE STYLE HEALTH PLANS
0262-00
3328-00
3949-00
LIFELINE UNDERWRITERS LIFE INS. CO.
LIFERE INSURANCE COMPANY
LIFEWISE HEALTH PLAN OF OREGON
LIFEWISE HEALTH PLAN OF WASHINGTON
LILLY HEALTH PLAN
2543-00
2639-00
3298-00
3829-00
2714-00
LINCOLN
LINCOLN
LINCOLN
LINCOLN
LINCOLN
LINCOLN
LINCOLN
LINCOLN
LINCOLN
0269-00
0270-00
3806-00
1915-00
3722-00
0271-00
0273-00
0274-00
1605-00
AMERICAN LIFE INS. CO.
BENEFIT LIFE CO.
FINANCIAL GROUP
GENERAL HOSPITAL EMPLOYEE BENEFIT TRUST
HERITAGE LIFE INC CO
HERITAGE LIFE INS. CO.
LIFE AND CASUALTY CO.
NATIONAL LIFE INS CO., THE
PARISH BOARD EMPLOYEES GROUP HEALTH
LINCOLN-INCOME LIFE INS. CO.
LINE CONSTRUCTION BENEFIT TRUST
LITTLE CAESAR INERNATIONAL INC
0272-00
1996-00
1505-00
LITTLE JOE'S WELDING INC(SELF-INSURED)
LIVING CENTERS OF AMERICA
1442-00
2932-00
LLOYDS UNDERWRITERS, LONDON
LOCAL #317
LOCAL #576 HEALTH AND WELFARE FUND
LOCAL #995 HEALTH & WELFARE FUND
LOCAL NO. 218 HEALTH & WELFARE FUND
2298-00
1997-00
1562-00
1650-00
1659-00
LOCAL
LOCAL
LOCAL
LOCAL
LOCAL
LOCAL
3667-00
3258-00
2007-00
1420-00
0721-00
1981-00
THIRTY THREE FUND
TWENTY FIVE
UNION NO 37
102
1098 FRINGE BENEFITS
130
LAM1R032
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LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
51
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
LOCAL 198 HEALTH AND WELFARE FUND
LOCAL 21 HEALTH & WELFARE FUND
LOCAL 3000
LOCAL 513 HEALTH AND WELFARE FUND
LOCAL 689 (LABORS UNION)
LOCAL 861 HEALTH AND WELFARE FUND
LOCKARD & WILLIAMS CO
LOCKHEED MEDICAL PLAN
LOFFLAND HEALTH COVERAGE PLAN
LOMAS FINANCIAL SECURITY INS. CO.
0856-00
1956-00
2230-00
1013-00
0967-00
1944-00
3205-00
1098-00
1906-00
0275-00
BATON ROUGE
BATON ROUGE
NEW ORLEANS
BRIDGETON
NEW ORLEANS
LAKE CHARLES
PASCAGOULA
BURBANK
TULSA
PHOENIX
LA
LA
LA
MD
LA
LA
MS
CA
OK
AZ
70805
70806
70125
63044
70116
70601
39568
91520
74101
85004
LONE STAR LIFE INS. CO.
LOOMIS COMPANY (SELF-INSURED)
LOS ANGELES HOTEL-RESTAURANT WELFARE FUND
LOSS MANAGEMENT INC
LOUISIANA AIRCRAFT INC
LOUISIANA ASSESSOR'S INSURANCE FUND
LOUISIANA BANK AND TRUST (SELF-INSURED)
0276-00
1967-00
1488-00
1682-00
2108-00
0985-00
1222-00
DALLAS
WYOMISSING
LOS ANGELES
LAFAYETTE
BATON ROUGE
ALEXANDRIA
SHREVEPORT
TX
PA
CA
LA
LA
LA
LA
75235
19610
90057
70505
70874
71309
71101
LOUISIANA
LOUISIANA
LOUISIANA
LOUISIANA
BUILDING MATERIALS DEALERS ASSOC.
CO-OP PLANS INC
DENTAL PLAN INC
DOCK CO.
0910-00
1064-00
1520-00
1319-00
BATON ROUGE
SHREVEPORT
BATON ROUGE
JEFFERSONVILLE
LA
LA
LA
IN
70898
71135
70896
47130
LOUISIANA
LOUISIANA
LOUISIANA
LOUISIANA
LOUISIANA
LOUISIANA
LOUISIANA
LOUISIANA
ELECTRICAL HEALTH & WELFARE PLAN
ELECTRICAL HEALTH FUND
EMPLOYERS SAFETY ASSOCIATION
GROUP ADMINISTRATORS INS
HEALTH COOPERATIVE
HEALTH COOPERATIVE
HEALTH SERVICE & INDEMNITY CO
HEALTHCARE CONNECTION
1530-00
3588-00
2494-00
1026-00
4056-00
3995-00
1732-00
9999-93
ALEXANDRIA
GOODLETTSVILLE
BATON ROUGE
LAFAYETTE
EAGAN
FOXBORO
BATON ROUGE
BATON ROUGE
LA
TN
LA
LA
MN
MA
LA
LA
71301
37070
70898
70503
55121
02035
70804
70809
LOUISIANA
LOUISIANA
LOUISIANA
LOUISIANA
LOUISIANA
LOUISIANA
LOUISIANA
LOUISIANA
HOSPITAL ASSOCIATION BENEFIT TRUST
HOUSING COUNCIL EMPLOYEE BENEFIT PLAN
INDEMNITY COMPANY
LABORERS HEALTH
LABORERS HEALTH & WELFARE PLAN L692
MACHINERY CO INC
NATIONAL LIFE INS. CO.
ORGAN PROCUREMENT AGENCY
1369-00
1438-00
2092-00
3653-00
1283-00
1991-00
0277-00
2926-00
PO BOX 52738
2061 BEAUMONT DRIVE
2706 S CLAIBORNE AVE
3449 HOLLENBERG SUITE 150
1407 DECATUR STREET
1715 COMMON STREET
P O BOX 1688
P O BOX 551
P O BOX 2847
234 NORTH CENTRAL AVENUE
STE. 646
POST OFFICE BOX 35047
P O BOX 7011
P O BOX 57924
P O BOX 52927
P O BOX 74170
PO BOX 2002
LOUISIANA TOWER
333 TRAVIS
PO BOX 14697
P O BOX 5279
P O BOX 65133
P O BOX 610
PH # 812-289-1636
P O BOX 5543
P O BOX 1449
P O BOX 80793
1116 COOLIDGE
P O BOX 21823
P O BOX 9108
P O BOX 15699
8550 UNITED PLAZA BLVD
STE 800
5220 GALAXIE
P O BOX 1349
P O BOX 5382
P O BOX 1449
2726 WOODDALE BLVD
P O BOX 51005
830 STATE STREET
3501 N CAUSEWAY BLVD
SUITE 940
P O BOX 80793
1175 NICHOLSON DR
P O BOX 27107
P O BOX 111
P O BOX 30010
P O BOX 5418
POST OFFICE BOX 5075
P O BOX 182223
P O BOX 849
JACKSON
HENDERSONVILLE
BOSSIER CITY
GOODLETTSVILLE
BATON ROUGE
SHREVEPORT
NEW ORLEANS
METAIRIE
MS
TN
LA
TN
LA
LA
LA
LA
39206
37075
71111
37070
70805
71135
70118
70002
BATON ROUGE
BATON ROUGE
ALBUQUERQUE
NORTH WILKESBORO
AUSTIN
CINCINNATI
SOUTHFIELD
CHATANOOGA
LUFKIN
LA
LA
NM
NC
TX
OH
MI
TN
TX
70898
70802
87125
28656
78755
45201
48037
37422
75902
LOUISIANA RETAILER ASSOCIATION
LOUISIANA SHERIFFS ASSOCIATION
LOVE LAACE HEALTH INSURANCE
LOWE'S COMPANIES INC,HEALTH BENEFITS
LOYAL AMERICAN LIFE INS CO
LOYAL AMERICAN LIFE INS. CO.
LOYALTY LIFE INS. CO.
LSU FIRST
LUFKIN INDUSTRIES (SELF-INSURED)
1964-00
1726-00
1903-00
1279-00
3747-00
0278-00
0279-00
3550-00
1948-00
LAM1R032
RUN: 09/24/16 07:28:56
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DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
52
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
LUHR BROS INC HEALTH BENEFIT PLAN
LUMBER INVESTOR'S INC
3184-00
1427-00
BALLWIN
SHREVEPORT
MO
LA
63021
71135
LUMBERMAN'S LIFE INSURANCE COMPANY
LUMBERMAN'S MUTUAL CASUALTY COMPANY
LUMENOS
LUTHERAN BROTHERHOOD
LUTHERAN PREFERRED
LYKES BROTHERS STEAMSHIP CO.
LYMAN AGENCY INC
M & L INDUSTRIES INC
M A PATOUT AND SONS SELF ASSURED
1337-00
0990-00
3166-00
1528-00
3094-00
2410-00
2271-00
2563-00
2964-00
INDIANAPOLIS
BATON ROUGE
HARRISBURG
MINNEAPOLIS
BROWNSBURG
TAMPA
NEW ORLEANS
SHREVEPORT
LAFAYETTE
IN
LA
PA
MN
IN
FL
LA
LA
LA
46268
70895
17106
55415
46112
33601
70113
71137
70508
M.D. IPA HEALTH PLAN
M.S. CARRIERS HEALTHCARE PLAN
M.W.L. INC
M-I DRILLING FLUIDS
MACCABEES MUTUAL LIFE INS. CO., THE
MACORI ADMINISTRATION
MACORI BENEFITS
MADISON BENEFIT ADMINISTRATOR
MAGCOBAR-IMCO (M-I) DRILLING FLUIDS CO.
MAGELLAN
MAGELLAN
MAGELLAN
MAGELLAN
MAGELLAN BEHAVIORAL HEALTH
MAGELLAN BEHAVIORAL HEALTH IN LOUISIANA
1912-00
2930-00
2045-00
2704-00
0282-00
3124-00
3818-00
1674-00
1942-00
3524-00
3525-00
3526-00
3519-00
3521-00
INT9-96
ROCKVILLE
JACKSON
NEW ORLEANS
HOUSTON
SOUTHFIELD
SPRING
SPRING
CHARLOTTE
HOUSTON
LEXINGTON
MARYLANE HEIGHTS
MARYLAND HEIGHTS
MAYLAND HEIGHTS
MARYLAND HEIGHTS
BATON ROUGE
MD
MS
LA
TX
MI
TX
TX
NC
TX
KY
MO
MO
MO
MO
LA
20850
39208
70113
77002
48076
77388
77388
28217
77242
40512
63043
63043
63043
63403
70810
MAGELLAN HEALTH SERVICES
MAGELLAN/HMO
9999-96
3527-00
AVON
MARYLAND HEIGHTS
CT
MO
06001
63043
MAGICAIRE (SELF-INSURED)
2492-00
JACKSON
MS
39213
MAGNA CARE
3179-00
GARDEN CITY
NY
11530
MAGNOLIA LIFE INS. CO.
0283-00
LAKE CHARLES
LA
70601
MAGNOLIA MANAGEMENT CORP
MAHONEY BENEFITS ADMINISTRATION
MAIL HANDLERS BENEFITS PLAN
MAIL HANDLERS INC.
MAISON BLANCHE; INC
MAJOR GROUP CLAIMS
MAKSIN MANAGEMENT CORPORATION
MALTA LIFE INS. CO.
MAMSI LIFE & HEALTH INS CO
MANAGE MED
MANAGED BENEFIT PLANS INC
MANAGED CARE ADMINISTRATION INC
MANAGED CARE OF AMERICA (MCA)
2028-00
3115-00
3514-00
0512-00
1758-00
2405-00
2303-00
0284-00
3091-00
2915-00
3215-00
1692-00
3357-00
13515 BARRET PKWY #265
PT COUPEE LUMBER-SELF INS
P O BOX 5756
P O BOX 5075
P O BOX 15258
P O BOX 69309
625 4TH AVE SOUTH
P O BOX 666
P O BOX 2390
820 HOWARD AVENUE
P O BOX 70100
1720 KALISTE SALOOM
STE C 7
4 TAFT COURT
2506 LAKELAND DR/STE 307
820 HOWARD AVE
440 LOUISIANA ST/STE 1600
25800 N. WESTERN HIGHWAY
19609 WIED RD
19609 WIED RD
1337 HUNDRED OAKS DR
P O BOX 42842
P O BOX 14586
P O BOX 2034
P O BOX 1959
P O BOX 1099
P O BOX 1118
10000 PERKINS ROWE
5TH FLOOR/SUITE 500
55 NOD RD
P O BOX 1119
ATTN: AUSHC
6508 DOGWOOD VIEW PKWY
SUITE A
825 E GATE BLVD
2ND FLOOR
SEVENTH FLOOR
MAGNOLIA LIFE BLDG.
160 DUCHARME RD
P O BOX 7260
P O BOX 8402
P O BOX 44242
P O BOX 91102
P O BOX 305181
14160 DALLAS PARKWAY #120
POST OFFICE BOX 55409
P O BOX 932
P O BOX 17264
P O BOX 744
4100 E 51 ST 1100
820 PARISH ST
OPELOUSAS
FT LAUDERDALE
LONDON
JACKSONVILLE
BATON ROUGE
NASHVILLE
DALLAS
JACKSON
FREDERICK
GREENVILLE
HACKETTSTOWN
TULSA
PITTSBURGH
LA
FL
KY
FL
LA
TN
TX
MS
MD
SC
NJ
OK
PA
70570
33338
40742
32231
70821
37230
75240
39216
21705
29606
07840
74135
15220
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
53
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
MANAGED HEALTH CARE INC
2049-00
HOUSTON
TX
77027
MANAGED PRESCRIPTION SERVICES
MANAGEMENT SERVICES INC
MANHANDLERS BENEFIT PLAN
MANHATTEN LIFE INSURANCE
MANUFACTURERS LIFE INS. CO., THE
2898-00
1866-00
1931-00
4048-00
0285-00
GREEN BAY
CHAMPAIGN
ROCKVILLE
HOUSTON
ONTARIO
WI
IL
MD
TX
ON
54344
61820
20850
77292
00000
MAPCO PETROLEUM INC. CASHIER HEALTH PLAN
MAPFRE LIFE INSURANCE CO
MARATHON OIL COMPANY GROUP INSURANCE
MARCO GROUP HEALTH PLAN
MARINE CORPS ASSN HEALTH PLAN
1671-00
3725-00
1627-00
1634-00
1018-00
TULSA
SAN JUAN
LAFAYETTE
TULSA
WASHINGTON
OK
PR
LA
OK
DC
74121
00936
70566
74121
20006
MARINE ENGINEERS BENEFICIAL ASSOCIATION
MARINE SYSTEMS INC
MARITIME ASSOCIATION I.L.A.WELFARE FUND
MARK TWAIN LIFE INS. CORP.
MARKEL INSURANCE CO
MARKHAM GRAY AND DENNIS INC
MARQUETTE NATIONAL LIFE INS CO
MARQUETTE NATIONAL LIFE INS. CO.
MARRIOT CORP MULTI-MED HEALTH CARE PLAN
MARSH & MCLENNAN
MARSH ADVANTAGE AMERICA
MARSH AFFINITY GROUP
2367-00
2174-00
1149-00
0286-00
3089-00
2481-00
H735-70
0287-00
0811-00
1371-00
3147-00
3595-00
BALTIMORE
SCHRIEVER
HOUSTON
OKLAHOMA CITY
GLEN ALLEN
KINSTON
CAMBRIDGE
CHICAGO
HORSHAM
TULSA
IOWA CITY
DES MOINES
MD
LA
TX
OK
VA
NC
MA
IL
PA
OK
IA
IA
21202
70395
77034
73154
23060
28501
02139
60630
19044
74114
52244
50306
MARSH AFFINITY GROUP
MARTCO EBT
MARTIN HOMES CENTER INC
MARYLAND CASUALTY COMPANY
MASKIN MANAGEMENT CORP
3596-00
3369-00
0916-00
2105-00
3633-00
DES MOINES
ALEXANDRIA
ALEXANDRIA
BATON ROUGE
CAMDEN
IA
LA
LA
LA
NJ
50306
71303
71016
70898
08103
MASS MARKET TRUST
MASSACHUSETTS CASUALTY INS. CO.
MASSACHUSETTS GENERAL LIFE INS. CO.
MASSACHUSETTS INDEMNITY AND LIFE INS. CO.
MASSACHUSETTS MUTUAL
MASSACHUSETTS MUTUAL LIFE INS. CO.
MASTER MATES & PILOTS
MATTHEWS TRUCKING COMPANY
1635-00
0288-00
0289-00
0290-00
3350-00
0291-00
1819-00
1268-00
PHOENIX
BOSTON
ENGLEWOOD
ATLANTA
LOS ANGELES
AUSTIN
LINTHICUM HEIGHTS
SHREVEPORT
AZ
MA
CO
GA
AZ
TX
MD
LA
85069
02109
80111
30359
90060
78714
21090
71137
MAXICARE
0767-01
LOS ANGELES
CA
90015
MAXICARE OF LOUISIANA
0767-00
NEW ORLEANS
LA
70112
MAXICARE OF NORTH TEXAS
1162-00
IRVING
TX
75039
MAXON ADMINISTRATORS,INC. - NAT'L COUNCIL
1219-00
IRVINGTON
NY
10533
MAXOR PLUS
3331-00
550 POST OAK BLVD
STE 400
1100 EMPLOYER BLVD
115 NORTH NEIL SUITE 409
P O BOX 6222
P O BOX 925688
200 BLOOR STREET, EAST
TORONTO 5
P O BOX 21628
P O BOX 70297
P O BOX 53266
P O BOX 21628
1729 H STREET NW
SUITE 100
1007 EASTERN AVE
P O BOX 239
11550 FUQUA SUITE 425
POST OFFICE BOX 18497
4600 COX RD
P O BOX 6159
P O BOX 391883
4800 NORTH KENNETH AVENUE
P O BOX 930
1579 E 21 ST.
P O BOX 1520
SENIOR MEDICAL INSURANCE
P O BOX 10439
P O BOX 10439
P O BOX 1110
P O DRAWER 1110
P O BOX 14560
TWO AQUARIUM DR
STE 200
P O BOX 39119
50 CONGRESS STREET
7887 E BELLEVIEW AVE
POST OFFICE BOX 29500
P O BOX 60007
P O BOX 149160
5700 HAMMONDSFERRY RD
SELF INSURED
P O BOX 78134
1149 S BROADWAY ST
STE 910
1515 POYDRAS ST
SUITE 1130
122 W JOHN CARPENTER FRWY
SUITE 200
OF CITIZENS,INC.
76 NORTH BROADWAY
320 SOUTHPOLK ST
AMARILLO
TX
79101
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
54
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
MAYFLOWER NATIONAL LIFE INS. CO.
MCA ADMINISTRATORS
MCCREW CARE CENTRAL
MCCRORY'S STORE (EMPLOYEE BENEFITS)
MCDERMOTT COMPREHENSIVE MEDICAL PLAN
0292-00
3314-00
3264-00
2035-00
1070-00
LAFAYETTE
PITTSBURGH
COLUMBIA
YORK
LOS ANGELES
IN
PA
SC
PA
CA
47904
15220
29260
17402
90030
MCDONALD'S HAMBURGERS
1653-00
BATON ROUGE
LA
70806
MCDONALDS INSURANCE PROGRAM
MCDONOUGH CAPERTON INS CO
MCELROY METAL INC
MCGOLDRICK OIL CO
MCGRIFF,SEIBELS AND WILLIAMS,INC
MCKEE FOODS CORPORATION
MCKENZIE TANK LINES (SELF-INSURED)
MCKESSON CORPORATION
3601-00
1343-00
1849-00
2167-00
1497-00
2965-00
2214-00
2160-00
COLUMBIA
CHARLSTON
SHREVEPORT
SHREVEPORT
BATON ROUGE
COLLEGEDALE
TALLAHASSEE
PORTLAND
SC
WV
LA
LA
LA
TN
FL
OR
29260
25332
71163
71129
70821
37315
32302
97205
MCNA INSURANCE COMPANY
9999-97
FORT LAUDERDALE
FL
33309
MCNEESE STUDENT INSURANCE
MD PHYSICIAN OF SOUTHWEST
MDX HAWAII
2542-00
1885-00
3858-00
DALLAS
LAKE CHARLES
HONOLULU
TX
LA
HI
75380
70602
96813
MED FIRST HEALTH PLANS
2773-00
METAIRIE
LA
70002
MED PLUS THRU NATIONAL INSURANCE SERVICES
MED STAR INSURANCE COMPANY
MED-CERT
MED-COMP USA-INC
MED-PAY INC
MED-TAC
MEDBEN
MEDCO
MEDCO
MEDCO DRUGS (GENERAL MOTORS HEALTH CARE PROG)
1075-00
2029-00
1490-00
1670-00
1729-00
2208-00
3404-00
3573-00
3646-00
2518-00
TAMPA
LAKE FOREST
GREENSBORO
METAIRIE
SPRINGFIELD
NATICK
NEWARK
ATLANTA
LEXINGTON
FAIR LAWN
FL
IL
NC
LA
MO
MA
OH
GA
KY
NJ
33630
60045
27420
70004
65808
01760
43058
30374
40512
07400
MEDCO HEALTH
MEDCO HEALTH SERVICES
MEDCORP SOUTHWEST INC
MEDCOST BENEFIT SERVICES LLC
MEDCOST PREFERRED
MEDI-PLUS
MEDICA INSURANCE CO
MEDICAL ADMINISTRATORS
MEDICAL BENEFIT PLAN
MEDICAL BENEFITS ADMINISTRATORS
MEDICAL BENEFITS ADMINISTRATORS
MEDICAL CONTROL INC
MEDICAL COST MANAGEMENT
MEDICAL INSURANCE ADMINISTRATORS
MEDICAL MUTUAL OF OHIO
3645-00
3354-00
2646-00
3989-00
3249-00
0944-00
3197-00
1581-00
2582-00
3788-00
3570-00
2711-00
2936-00
0836-00
2957-00
401 EARL AVENUE
820 PARISH ST
P O BOX 6702
2955 E MARKET ST
P BOX 30654
TERMINAL ANNEX
MCBR MANAGEMENT CO
7077 SOUTH CHOCTAW
P O BOX 6702
P O BOX 3262
P O BOX 1148
8808 MCGOLDRICK DR
P O BOX 2550
P O BOX 2078
P O BOX 1176
720 SW WASHINGTON ST
4TH FLOOR
200 W CYPRESS CREEK RD
STE 500
P O BOX 809025
P O BOX 1832
500 ALA MONANA BLVD
STE 2-200
3500 N CAUSEWAY BLVD
SUITE 520
P O BOX 30324
400 FIELD DRIVE
POST OFFICE BOX 26028
P O BOX 788
P O BOX 10909
4 CHRYSLER ROAD
P O BOX 1099
P O BOX 740800
P O BOX 14711
P O BOX 6121
11900 TOLLITT DR
P O BOX 69316
P O BOX 650322
P O BOX 9201
P O BOX 25987
P O BOX 25307
777 THIRD ST
P O BOX 659752
217 BROADWAY
P O BOX 171720
P O BOX 389
P O BOX 950
9649 WEBB CHAPEL RD
P O BOX 6794
PO BOX 619001
P O BOX 6018
HARRISBURG
DALLAS
AUSTIN
WINSTON SALEM
WINSTON SALEM
DES MOINES
SAN ANTONIO
MONTICELLO
SAN ANTONIO
DUBUQUE
FOREST HILL
DALLAS
METAIRIE
POMPANO BEACH
CLEVELAND
PA
TX
TX
NC
NC
IA
TX
NY
TX
IA
MD
TX
LA
FL
OH
17106
75265
78766
27114
27114
50309
78265
12701
78217
52004
21050
75220
70009
33061
44101
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
55
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
MEDICAL PLANS INC
MEDICAL PLANS OF LOUISIANA INC
MEDICAL SEVICES CORPORATION
MEDICAL TRUST ADMINISTRATORS
MEDICARE A AND B
MEDICARE SERVICES
0860-00
0777-00
1724-00
1863-00
MOL0-01
4035-00
JACKSON
METAIRIE
ATLANTA
CLARION
BATON ROUGE
MS
LA
GA
IA
LA
AR
39216
70009
30339
50525
70809
72203
MEDICLAIM
MEDICO INSURANCE COMPANY
MEDICO LIFE INS. CO.
MEDIMET
MEDIMPACT
2809-00
3932-00
0293-00
2288-00
3394-00
DANVILLE
DES MOINES
OMAHA
UTICA
SAN DIEGO
IL
IA
NE
NY
CA
61834
50306
68105
13504
92131
MEDIMPACT
3421-00
SAN DIEGO
CA
92131
MEDIPLAN
MEDISHARE
MEDPAY EXPRESS LLC
MEDTRAK
2063-00
3436-00
3464-00
4113-00
FAIRLAWN
STERLING
LAKE CHARLES
OVERLAND
NJ
IL
LA
KS
07410
61081
70602
66210
MEGA LIFE
MEGA LIFE AND HEALTH INSURANCE
MEGELLAN
MEGELLAN
2026-00
3560-00
3522-00
3520-00
IRVING
NORTH RICHLAND HILLS
MARYLAND HEIGHTS
MARYLAND HEIGHTS
TX
TX
MO
MO
75015
76182
63043
63043
MEGELLAN CLAIMS
MEGELLAN/PPO
MEISEL PHOTOCHROME (SELF-INSURED)
3528-00
3523-00
1950-00
MAR
GREENSBORO
ADDISON
MO
NC
TX
63043
27402
75001
MELDRUM BUSINESS SYSTEMS
MEMBER SERVICE ADMINISTRATOR
MEMORIAL HEALTH NETWORK
2631-00
2021-00
2546-00
SHREVEPORT
TULSA
HOUSTON
LA
OK
TX
71137
74102
77074
MEMORIAL HERMAN BAPTIST
MENNONITE MUTUAL AID ASSOCIATION
3501-00
1484-00
HOUSTON
GOSHEN
TX
IN
77274
46526
MENTAL HEALTH NETWORK
MERCER ADMINISTRATION
MERCER ADMINISTRATION
3223-00
3311-00
3427-00
AUSTIN
IOWA CITY
ST LOUIS
TX
IA
MO
78720
52244
63101
MERCHANT'S DUTCH EXPRESS INC
MERCK MEDCO RX OF TEXAS (MMRX)
MERCY BAPTIST/SELECT HEALTH
1925-00
2878-00
2731-00
SHREVEPORT
DALLAS
NEW ORLEANS
LA
TX
LA
71135
75265
70115
MERCY CARE
MERCY CARE ADVANTAGE
MERCY HEALTH PLANS
MERCY 50 + HEALTH CARE
MERIDIAN BENEFITS INC
MERIDIAN HEALTH PLAN
MERIT INDUSTRIES (SELF-INSURED)
3900-00
H558-00
3384-00
1603-00
3117-00
4028-00
1975-00
PO BOX 5364
P O BOX 6215
1995 NORTHPARK PLACE #290
P O BOX 540
FOR MOLINA USE ONLY
P O BOX 8082
LITTLE ROCK
P O BOX 4007
P O BOX 10386
3860 LEAVENWORTH STREET
P O BOX 3018
10680 TREENA ST
5TH FLR
10680 TREENA ST
5TH FL.
P O BOX 590
P O BOX 674
P O BOX 2108
7101 COLLEGE BLVD
STE 1000
P O BOX 152152
P O BOX 982009
P O BOX 1189
ATTN: BLUE LINKS
P O BOX 1568
P O BOX 1655
P O BOX 26106
GENELCO INCORPORATED
P O BOX 915
P O BOX 70010
P O BOX 3028
9494 SOUTHWEST FREEWAY
SUITE 300
P O BOX 742567
1110 NORTH MAIN ST
P O BOX 483
P O BOX 209010
P O BOX 4542
701 MARKET ST
SUITE 1350
P O BOX 51005
P O BOX 650322
4500 MAGNOLIA ST
SUITE 400
P O BOX 52089
P O BOX 52089
P O BOX 4568
301 N JEFFERSON DAVIS PKW
P O BOX 311700
1001 WOODARD AVE/STE 5
P O BOX 74330
PHOENIX
PHOENIX
SPRINGFIELD
NEW ORLEANS
WAYNE
DETROIT
BATON ROUGE
AZ
AZ
MO
LA
NJ
MI
LA
85072
85072
65808
70119
07470
48226
70879
LAM1R032
RUN: 09/24/16 07:28:56
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DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
56
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
MERIT LIFE INS. CO.
MERITAGE EMPLOYER SERVICES
0294-00
3134-00
EVANSVILLE
RENO
IN
NV
47708
89501
MERITAIN
MERITAIN HEALTH
MERITAIN HEALTH
MERITAIN HEALTH
MERITAIN HEALTH
MERITAIN HEALTH
MERITAIN INSURANCE
MERVYN'S HEALTH PLAN TRUST
MESA LTD PARTNERSHIP MEDICAL BENEFIT PLAN
4026-00
3321-00
3458-00
3696-00
3692-00
3643-00
3329-00
1221-00
1404-00
LUBBOCK
AMHERST
MINNEAPOLIS
SHREVEPORT
RICHARDSON
LUBBOCK
AMHERST
SAN JOSE
AMARILLO
TX
NY
MN
LA
TX
TX
NY
CA
TX
79408
14226
55427
71137
75088
79493
14226
95150
79801
MET LIFE DENTAL
METALCRAFTERS UNITED AUTO WORKERS LOCAL 449
METHODIST CARE
3581-00
1651-00
3127-00
LEXINGTON
PEORIA
HOUSTON
KY
IL
TX
40512
61614
77046
METLIFE DENTAL
METLIFE INSURANCE COMPANY OF CT
METLIFE LTC GROUP
METLIFE NETWORK (SHELL HSM PLAN)
METRA HEALTH
METRA HEALTH PLANS
METRIC CONSTRUCTORS
3657-00
3626-00
3853-00
1803-00
2775-00
2696-00
2211-00
EL PASO
OMAHA
LEXINGTON
AUSTIN
DALLAS
SALT LAKE CITY
CHARLOTTE
TX
NE
KY
TX
TX
UT
NC
79998
68175
40512
78744
75265
84130
28210
METRO AMBULANCE
METROPLUS HEALTH PLAN
METROPOLITAN
2375-00
H042-30
0295-06
MONROE
BIRMINGHAM
DALLAS
LA
AL
TX
71211
35238
75266
METROPOLITAN GROUP HEALTH
0295-04
UTICA
NY
13501
METROPOLITAN INS.
METROPOLITAN INSURANCE
1089-00
0295-07
JOHNSTOWN
MARIETTA
PA
GA
15904
30067
METROPOLITAN INSURANCE
METROPOLITAN LIF
METROPOLITAN LIFE GROUP CLAIMS
METROPOLITAN LIFE INS CO
METROPOLITAN LIFE INS. CO.
MGIC LIFE INS. CORP.
MGIS COMPANIES
MHA DIVERSIFIES SERVICES INC
MHC EMPLOYEE BENEFIT TRUST
MHC EMPLOYEE BENEFITS TRUST
MHEALTH
0295-05
0295-03
1031-00
0295-02
0295-00
0280-00
1804-00
2172-00
3919-00
1612-00
3930-00
601 N.W. SECOND STREET
300 EAST SECOND ST
15TH FLOOR
P O BOX 90802
P O BOX 9501
P O BOX 27267
P O BOX 2886
P O BOX 853921
P O BOX 94488
P O BOX 765
P O BOX 50011
1 MESA SQUARE
P O BOX 2009
P O BOX 14093
612 WEST GLEN AVE
TWO GREENWAY PLAZA
SUITE 500
P O BOX 981282
3316 FARNAM ST
P O BOX 14407
1701 DIRECTORS BLVD
P O BOX 650403
P O BOX 30998
TWO SOUTH EXECUTIVE PARK
6135 PARK ROAD
P O BOX 4825
P O BOX 381508
P O BOX 66051
12902 E 51ST ST ZIP:74134
CLAIMS KODAK UNIT
501 BLEEKER ST
500 SCHOOL HOUSE ROAD
GROUP CLAIMS DEPT
1130 N CASE PARKWAY
P O BOX 2925
500 SCHOOL HOUSE RD
PO BOX 7202
P O BOX 470
P O BOX 2072
222 NORTH DEARBORN STREET
600 N PARK
P O BOX 16707
P O BOX 1110
P O BOX 1110
7737 SOUTH WEST FREEWAY
STE C97
P O BOX 48098
P O BOX 7802
P O BOX 7802
3044 WEST GRAND BLVD.
P O BOX 95669
ENGLEWOOD
JOHNSTOWN
SAN FRANCISCO
WARWICK
AURORA
CHICAGO
BRENHAM
JACKSON
ALEXANDRIA
ALEXANDRIA
HOUSTON
CO
PA
CA
RI
IL
IL
TX
MS
LA
LA
TX
80150
15904
94120
02887
60507
60601
77833
39236
71309
71309
77074
JACKSONVILLE
LONDON
LONDON
DETROIT
HOFFMAN ESTATES
FL
KY
KY
MI
IL
32247
40742
40742
48202
60195
MHF INSURANCE ADMINISTRATORS INC
MHNET
MHNET
MIC LIFE INS. CORP.
MICACARE
- CHEVRON
3165-00
4034-00
H061-02
0281-00
3471-00
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
57
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
MICHIGAN EDUCATION SPECIAL SERVICES
MICHIGAN HEALTH INSURANCE CO
MID AMERICA ASSURANCE CO OF LA
MID AMERICA MUTUAL LIFE
MID SOUTH MEDICAL BENEFIT PLAN
MID-AMERICA LUMBERMENS ASSOCIATION
MID-AMERICA NATIONAL
MID-ATLANTIC BENEFIT ADMINISTRATORS
MID-CONTINENT LIFE INS. CO.
MID-SOUTH INSURANCE CO.
MID-SOUTH LIFE INS. CO.
MID-WEST NATIONAL LIFE INS CO
MID-WEST NATIONAL LIFE INS. CO. OF TN
MID-WESTERN LIFE INS CO
MIDDLE ATLANTIC LIFE INS CO
MIDLAND ENTERPRISE HEALTH CARE PLAN
MIDLAND NATIONAL LIFE INS. CO.
MIDSOUTH NATIONAL BANK
MIDWEST BENEFITS
MIDWEST EMPLOYEE LEASING INC
MIDWEST NATIONAL LIFE
MIDWEST OPERATING ENGINEERS WELFARE FUND
2751-00
3272-00
0296-00
2152-00
1414-00
2447-00
0999-00
1425-00
0297-00
1231-00
0299-00
1519-00
0301-00
0300-00
1661-00
1745-00
0298-00
2290-00
1145-00
2235-00
3615-00
1295-00
EAST LANSING
MI
ANN ARBOR
MI
BATON ROUGE
LA
ROSEVILLE
MN
JACKSON
MS
LEAWOOD
KS
KANSAS CITY
MO
ROCKVILLE
MD
OKLAHOMA CITY
OK
HOUSTON
TX
JACKSON
MS
IRVING
TX
NASHVILLE
TN
EL PASO
TX
RICHARDSON
TX
PORT ALLEN
LA
SIOUX FALLS
SD
LAFAYETTE
LA
SOUTHFIELD
MI
CEDAR RAPIDS
IA
NORTH RICHLAND HILLS TX
COUNTRYSIDE
IL
48826
48105
70808
55113
39205
66206
64114
20850
73106
77079
39216
75015
37217
79998
75083
70767
57101
70502
48075
52406
76182
60525
MIDWEST SECURITY ADMINISTRATORS
MILICO INSURANCE CO
MILLERS LIFE INS. CO. OF TX, THE
MILLETTE ENTERPRISES, INC
MINISTERS LIFE - A MUTUAL LIFE INS. CO.
MINNESOTA COMPREHENSIVE HEALTH ASSO
MINNESOTA MUTUAL LIFE INS. CO., THE
MISCO INC (SELF INSURED COMPANY)
MISSION PETROLEUM CARRIERS/MEDICAL BENEFIT PLAN
MISSISSIPPI ADMINISTRATIVE SERVICE
MISSISSIPPI CARPENTER BENEFITS PLAN
MISSISSIPPI HOSP EMPLOYEE BENEFIT TRUST INS
MISSISSIPPI POWER COMPANY MEDICAL BENEFIT PLAN
MISSISSIPPI SELECT HEALTH CARE
MISSOURI NATIONAL LIFE INS. CO.
MISSOURI PACIFIC EMPLOYEES' HEALTH ASSOCIATION
MISSOURI PACIFIC R R CO
MMM HEALTHCARE
MO KAN TEAMSTERS
3499-00
1314-00
0302-00
1579-00
0303-00
3640-00
0304-00
1126-00
2588-00
2496-00
1802-00
1217-00
1331-00
3031-00
0305-00
1376-00
0762-00
H400-30
2685-00
ONALASKA
ATLANTA
FORTH WORTH
PASCAGOULA
MINNEAPOLIS
SALT LAKE CITY
ST. PAUL
MONROE
SAN ANTONIO
OXFORD
JACKSON
JACKSON
GULFPORT
GULFPORT
KANSAS CITY
ST LOUIS
ST LOUIS
SAN JUAN
KANSAS CITY
WI
GA
TX
MS
MN
UT
MN
LA
TX
MS
MS
MS
MS
MS
MO
MO
MS
PR
MO
54650
30559
76101
39567
55416
84130
55101
71211
78217
38655
39236
39206
39501
39503
64112
63150
63103
00936
64111
MOBIL BENEFITS SERVICE CENTER
MODA OREGON HEALTH PLAN
MODERN AMERICAN LIFE INS. CO.
MOLINA HEALTHCARE INC
MOLINA HEALTHCARE OF ILLINOIS
MOLINA HEALTHCARE OF ILLINOIS
MOLINA HEALTHCARE OF MICHIGAN
MOLINA OF NEW MEXICO
3082-00
4102-00
0306-00
3440-00
4101-00
4045-00
H592-60
1000-09
P O BOX 2560
2301 COMMONWEALTH BLVD
4815 JAMESTOWN AVE
1801 W COUNTRY ROAD B
P O BOX 188
P O BOX 6353
PO BOX 8728
103 S ADAMS ST
POST OFFICE BOX 60269
16010 BARKERS PT #265
POST OFFICE BOX 4744
P O BOX 152152
POST OFFICE BOX 17423
P O BOX 981606
P O BOX 831151
P O BOX 108
ONE MIDLAND PLAZA
P O BOX 3745
P O BOX 200
P O BOX 2166
P O BOX 982017
6150 JOLIET ROAD
PH #(312)482-7300
P O BOX 266
P O BOX 29500
900 MONROE STREET
P O BOX 1177
3100 WEST LAKE STREET
P O BOX 30990
400 NORTH ROBERT STREET
2005 JACKSON ST
P O BOX 171720
P O DRAWER 1400
P O DRAWER 16747
5220 GALAXY DRIVE
P O BOX 4079
14110 AIRPORT RD
4646 ROANOKE PARKWAY
P O BOX 500352
201 N 13TH ST RM 1001
P O BOX 71305
3100 BROADWAY
SUITE 400
P O BOX 1569
P O BOX 40384
POST OFFICE BOX 7007
P O BOX 22668
P O BOX 540
1520 KENISHINTON RD
100 W BIG BEAVER/STE 600
8801 HORIZON BLVD
SECAUCUS
PORTLAND
SPRINGFIELD
LONG BEACH
LONG BEACH
OAK BROOK
TROY
ALBUQUERQUE
NJ
OR
MO
CA
CA
IL
MI
NM
07096
97240
65801
90801
90801
60523
48084
87113
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
58
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
MONARCH LIFE INS. CO.
MONTGOMERY WARD LIFE INS. CO.
0307-00
0308-00
SPRINGFIELD
SCHAUMBURG
MA
IL
01133
60194
MONUMENT BUILDERS OF NORTH AMERICA
MONUMENTAL GENERAL INS. CO.
MONUMENTAL LIFE INSURANCE CO
MONY FINANCIAL SERVICES GROUP CHAINS
1768-00
0309-00
0310-00
0922-00
EVANSTON
BALTIMORE
SCRANTON
DALLAS
IL
MD
PA
TX
60201
21202
18504
75231
MOODY PRICE EMPLOYEE BENEFIT TRUST
MOREHOUSE GEN HOSP MEDICAL BENEFITS PLAN
2299-00
0946-00
BATON ROUGE
BASTROP
LA
LA
70805
71220
MORGAN GROUP RESOURCE
MORGAN-WHITE ADMINISTRATORS, INC
MORRIS & DICKSON CO., LTD.
MORRIS ASSOCIATES
MORRIS MANAGEMENT INCORPORATED
MORTON INTERNATIONAL GROUP BENEFIT
MORTON-THIOKOL
MOTEL 6
MOTION PICTURE HEALTH & WELFARE FUN
MOTIVATION EDUCATION AND TRAINING INC
MOTOROLA
MOUNTAIN CLAIMS MGMT
MOUNTAIN STATES ADMINISTRATION
3605-00
3336-00
2508-00
3218-00
0992-00
1554-00
0803-00
2046-00
4121-00
2361-00
2240-00
3620-00
2547-00
DULUTH
JACKSON
SHREVEPORT
NEW PORT RICHEY
COLUMBIA
NEW IBERIA
MARSHALL
DALLAS
NORTH HOLLYWOOD
CLEVELAND
PHOENIX
FRUITLAND
AURORA
GA
MS
LA
FL
LA
LA
TX
TX
CA
TX
AR
IN
CO
30096
39236
77135
34656
71418
70562
75670
75240
91604
77328
85038
83619
80014
MS ADMINISTRATIVE SERVICES
MSH INTERNATIONAL
MULHEARN PROTECTIVE INSURANCE CO
MULTI PLAN NETWORK
MULTIPLAN
MULTIPLAN INC
MULTIPLE BUSINESS BENEFIT FUND
MURPHY OIL CO USA INC
MURPHY'S LEASE & WELDING SERV
2368-00
3945-00
1764-00
2855-00
4092-00
3831-00
1028-00
2333-00
0827-00
OXFORD
BEEBE PLAIN
MONROE
OXFORD
SPRINGFIELD
DEPERE
BIRMINGHAM
ELDORADO
ABBEYVILLE
MS
VT
LA
MS
KS
WI
AL
AR
LA
38655
05823
71210
38655
01104
54115
35205
71730
70510
MURRAY ENVELOPE CORP
2094-00
HATTIESBURG
MS
39404
MUTUAL
MUTUAL
MUTUAL
MUTUAL
MUTUAL
MUTUAL
MUTUAL
MUTUAL
MUTUAL
MUTUAL
1933-00
0311-00
1060-00
2027-00
0312-00
1324-00
2745-00
1833-00
0743-00
0526-00
1250 STATE STREET
MONTGOMERY WARD INS TOWER
200 N. MARTINGALE ROAD
1612 CENTRAL ST
MUNSEY BUILDING
P O BOX 97
SUITE 280 LOCK BOX #4
8144 WALNUT HILL LANE
2966 LUPINE AVE
MOREHOUSE GEN HOSPITAL
PO BOX 1060
P O BOX 100043
P O BOX 16708
P O BOX 51367
P O BOX 5001
P O BOX 1209
P O BOX 1496
P O BOX 1149
P O BOX 809092
P O BOX 1118
P O BOX 1749
P O BOX 209005
P O BOX 1008
2530 SOUTH PARKER RD
#606
P O BOX 1400
P O BOX 77
207 TALEMAQUE
P O DRAWER 1400
2077 ROOSEVELT AVE
P O BOX 5007
P O BOX 3326-A
200 PEACH ST
HEALTH & WELFARE TRUST
1828 S HENRY STREET
GROUP INSURANCE PLAN
P O BOX 15789
P O BOX 42096
520 BROAD STREET
P O BOX 15699
P O BOX 2976
1740 BROADWAY
P O BOX 14
220 EMERSON PLACE
P O BOX 6963
MUTUAL OF OMAHA PLAZA
505 N. ERVAY ST.
POST OFFICE BOX 3189
P O BOX 6097
P O BOX 3368
P O BOX 3477
1515 S 75TH STREET
OKLAHOMA CITY
NEWARK
BATON ROUGE
MILWAUKEE
NEW YORK
HOUSTON
DAVENPORT
LINCOLN
OMAHA
DALLAS
OK
NJ
LA
WI
NY
TX
IA
NE
NE
TX
73123
07101
70895
53201
10019
77001
52801
68506
68175
75221
ROCKVILLE
OMAHA
OMAHA
MD
NE
NE
20850
68103
68103
ASSURANCE ADMINISTRATORS
BENEFIT LIFE INS. CO., THE
EMPLOYEE'S TRUST #2
GROUP
LIFE INS. CO. OF NY, THE
LIFE INSURANCE
MEDICAL
OF NEW YORK REMEMBER GRP HOSP PLAN
OF OMAHA
OF OMAHA INS. CO. SOUTHWEST DIVISION
MUTUAL OF OMAHA, POSTAL SUPERVISOR'S HEALTH PLAN
MUTUAL PLAN ADMINISTRATORS INC
MUTUAL PROTECTIVE INSURANCE CO
1483-00
2312-00
0917-00
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
59
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
MUTUAL SAVINGS LIFE INS. CO.
MUTUAL SECURITY LIFE INS. CO.
MUTUAL SERVICE LIFE INS CO.
MVP HEALTHCARE
N A G E HEALTH BENEFIT PLAN
N.L. INDUSTRIES (SELF-INSURED)
N.L.J. ADMINISTRATORS
N.O GLASSWORKERS & PICTORIAL PAINTERS LOCAL #936
0313-00
0314-00
1879-00
H961-50
1296-00
1527-00
2315-00
2246-00
DECATUR
FORT WAYNE
ST PAUL
SCHENECTADY
WASHINGTON
HOUSTON
NEW TOWN
NEW ORLEANS
AL
IN
MN
NY
DC
TX
PA
LA
35601
46805
55164
12301
20005
77205
18940
70127
N.W. LA. CARPENTER'S HEALTH & WELFARE FUND
2406-00
SHREVEPORT
LA
71118
NABORS LOFFLAND DRILLING CO.
NAEDA GROUP INSURANCE TRUST
NAHGA CLAIMS SERVICES
NAPA GROUP INSURANCE SERVICES
2421-00
1820-00
3684-00
1412-00
NEW IBERIA
ST. LOUIS
BRIDGTON
WESTMONT
LA
MO
MA
IL
70562
63127
04009
60559
NAPP
NARFE INSURANCE ADM
NARMON HOLDINGS INSURANCE COMPANY
NASA
NAT'L ELECTRICAL CONTRACTORS ASSOC GROUP INS.TRUST
NATCHITOCHES PARISH HOSPITAL
NATIONAL ACCIDENT INSURANCE UNDERWRITERS INC
2519-00
0774-00
1061-00
2620-00
2599-00
0723-00
2338-00
HOUSTON
WASHINGTON
VILLEPLATTE
NORTH RICHLAND HILLS
ALEXANDRIA
NATCHITOCHES
ARLINGTON HEIGHTS
TX
DC
LA
TX
VA
LA
IL
77054
20007
70586
76182
22314
71457
60005
NATIONAL
NATIONAL
NATIONAL
NATIONAL
NATIONAL
NATIONAL
2981-00
2376-00
1561-00
0317-00
0318-00
3817-00
POST OFFICE BOX 2222
3000 EAST U.S. 30 BY-PASS
P O BOX 64035
P O BOX 2207
1313 L STREET NW
P O BOX 62107
P O BOX 2710
HEALTH & WELFARE PLAN
10054 I-10 SERV RD,BLDG 1
2715 MACKEY OFFICE PL
#207
P O BOX 9709
10877 WATSON ROAD
P O BOX 189
700 EAST OGDEN AVE
STE 203
2646 S LOOP WEST/STE 280
2135 WISCONSIN AVE
LITHCOTE ROAD
P O BOX 982009
1421 PRINCE ST/STE 320
P O BOX 2009
85 WEST ALGONQUIN RD
5TH FLOOR
P O BOX 925426
P O BOX 12190
1750 HENNETIN AVENUE
7887 E BELLEVIEW AVE
1599 LITTLETON ROAD
7130 COLUMBIA GATEWAY
SUITE A
C/O TAYLOR CARROWAY AGCY
P O BOX 1459
P O BOX 612067
CONSOLIATED ADMINISTRATOR
S.INC P O BOX 37429
100 INDIANA AVE
20547 WAVERLY COURT
410 WEST FLAGLER ST
15333 JFK BLVD/STE 505
8000 CORPORATE DRIVE
P O BOX 3970
TWO PARK AVENUE
110 GIBRALTER RD
SUITE 116
HEYBURN BUILDING/7TH FL
332 WEST BROADWAY
P O BOX 1459
222 WEST LAS COLINAS BLVD
SUITE 1500
4242 LINDELL BLVD
HOUSTON
ALEXANDRIA
MINNEAPOLIS
ENGLEWOOD
PARSIPPANY
COLUMBIA
TX
LA
MN
CO
NJ
MD
77292
71315
55403
80111
07054
21046
BILOXI
MS
39533
DALLAS
RALEIGH
TX
NC
75261
27627
WASHINGTON
ASHBURN
MIAMI
HOUSTON
LANDOVER
LAFAYETTE
NEW YORK
HORSHAM
DC
VA
FL
TX
MD
LA
NY
PA
20001
20149
33134
77032
20785
70502
10016
19044
LOUISVILLE
KY
40202
BILOXI
IRVING
MS
TX
39533
75039
ST LOUIS
MO
63108
ADMINISTATORS
AFFILIATED INVESTORS LIFE INS CO
AMERICAN LIFE AND CASUALTY COMPANY
AMERICAN LIFE INS. CO.
AMERICAN LIFE INS. CO. OF PA
ASBESTOS WORKERS MEDICAL
NATIONAL ASSOC. BUSINESS TRUST
1480-00
NATIONAL ASSOCIATION FOR THE SELF EMPLOYED
NATIONAL ASSOCIATION OF HOME BUILDERS
1780-00
1947-00
NATIONAL
NATIONAL
NATIONAL
NATIONAL
NATIONAL
NATIONAL
NATIONAL
NATIONAL
0524-00
0948-00
1071-00
2702-00
1852-00
1029-00
0319-00
1458-00
ASSOCIATION OF LETTER CARRIERS
ASSOCIATION OF LETTER CARRIERS
ASSOCIATION OF MUSIC MERCHANTS(NAMM)
ASSOCIATION OF PREFERRED PROVIDERS
AUTOMATIC SPRINKLER INDUSTRY WELFARE FUND
BENEFIT ADMINISTRATION
BENEFIT LIFE INS. CO.
BENEFITS CORPORATION
NATIONAL BUSINESS ACCT TRUST
1475-00
NATIONAL BUSINESS ASSOCIATION TRUST
NATIONAL CARE NETWORK
1536-00
3796-00
NATIONAL CASUALTY COMPANY
0840-00
LAM1R032
RUN: 09/24/16 07:28:56
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DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
60
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
NATIONAL CATHOLIC SCHOOL INSURANCE
1265-00
STILLWATER
MN
55082
NATIONAL CINEMA SERVICE CORPORATION
NATIONAL CLAIM ADMINISTRATORS INC
NATIONAL COUNCIL OF ALLIED EMPLOYEES-LOCAL 55
2956-00
1552-00
2179-00
KANSAS CITY
WILLISTON
ENCINO
MO
NY
CA
64141
11596
91436
NATIONAL DENTAL PLANS INC
NATIONAL ELEVATOR INDUSTRY HEALTH BENEFIT CO
NATIONAL ELEVATOR INDUSTRY HLTH BEN
2379-00
2507-00
3785-00
BATON ROUGE
NEWTOWN SQUARE
NEWTOWN SQUARE
LA
PA
PA
70879
19073
19073
NATIONAL EMPLOYEE BENEFIT ADMINISTRATORS
NATIONAL EMPLOYEE BENEFIT SERVICES INC
NATIONAL EMPLOYEE BENEFIT TRUST
0833-00
1813-00
1113-00
HOUSTON
SCARBOROUGH
ATLANTA
TX
ME
GA
77043
04074
30340
NATIONAL
NATIONAL
NATIONAL
NATIONAL
NATIONAL
1053-00
2089-00
1448-00
0320-00
1411-00
SCHOOL INSURANCE ONLY
P O BOX 82
BOX 41029
11 HILLSIDE AVE
HEALTH & WELFARE PLAN
16133 VENTURA BLVD
P O BOX 77210
P O BOX 477
19 CAMPUS BLVD
SUITE 200
10810 OLD KATY ROAD
P O BOX 1239
3855 PRESIDENTIAL PARKWAY
N E
P O BOX 1280
13530 INWOOD RD
P O BOX 6333
POST OFFICE BOX 2986
777 MAIN ST
SUITE 900
P O BOX 26050
777 MAIN STREET
CONTINENTAL PLAZA
P O BOX 619075
666 FIFTH AVENUE
P O BOX 619999
9110 EAST NICHOLLS AVE
STE 320
300 GALLERIA PARKWAY
SUITE 650, P O BOX 723049
POST OFFICE BOX 33888
LIBERTY PARK
ADMINISTRATION OFFICES
NORTHEAST LA.ALUMNI ASSN.
8330 MOBERLY LANE
P O BOX 30324
P O BOXX 64035
POST OFFICE BOX 3668
P O BOX 37502
150 ALLENDALE ROAD
AMERICAN GENERAL CENTER
NATIONAL LIFE DRIVE
P O BOX 52616
404 LAFAYETTE STREET
P O BOX 721900
11620 WILSHIRE BLVD
P O BOX 1170
2711 CEDAR SPRINGS
POST OFFICE BOX 2900
1445 NORTH LOOP WEST
STE 500
NASHVILLE
DALLAS
ROCKVILLE
OVERLAND PARK
FORTHWORK
TN
TX
MD
KS
TX
37202
75244
70850
66201
76102
OVERLAND
FORT WORTH
KS
TX
66225
76102
DALLAS
NEW YORK
DFW AIRPORT
ENGLEWOOD
TX
NY
TX
CO
75261
10103
75261
80112
ATLANTA
GA
30339
SHREVEPORT
FRAZER
VALLEY FORGE
DALLAS
LA
PA
PA
TX
71130
19355
19494
75227
TAMPA
ST PAUL
LITTLE ROCK
OAK PARK
VALLEY FORGE
NASHVILLE
MONTPELIER
NEW ORLEANS
NEW YORK
HOUSTON
LOS ANGELES
PORT WASHINGTON
DALLAS
LITTLE ROCK
HOUSTON
FL
MN
AR
MI
PA
TN
VT
LA
NY
TX
CA
NY
TX
AR
TX
33630
55164
72203
48237
19481
37250
05602
70152
10003
77272
90025
11050
75201
72203
77008
EMPLOYERS TRUST
FAMILY CARE LIFE INSURANCE CO
FEDERATION OF FEDERAL EMPLOYEES
FIDELITY LIFE INS. CO.
FINANCIAL INSURANCE CO
NATIONAL FIRE INSURANCE OF PITT
NATIONAL FOUNDATION LIFE INS. CO.
4105-00
0321-00
NATIONAL
NATIONAL
NATIONAL
NATIONAL
1938-00
0323-00
0322-00
2145-00
GROUP LIFE
HEALTH & WELFARE LIFE INS. ASSN., INC.
HEALTH INS. CO.
HEALTH SYSTEMS INC
NATIONAL HEALTHCARE INC
2011-00
NATIONAL
NATIONAL
NATIONAL
NATIONAL
HERITAGE EMPLOYEE BENEFIT TRUST
HOME LIFE ASSURANCE CO.
HOME LIFE ASSURANCE COMPANY
INSURANCE ADMINISTRATORS
1572-00
0324-00
0829-00
1097-00
NATIONAL
NATIONAL
NATIONAL
NATIONAL
NATIONAL
NATIONAL
NATIONAL
NATIONAL
NATIONAL
NATIONAL
NATIONAL
NATIONAL
NATIONAL
NATIONAL
NATIONAL
INSURANCE SERVICES,INC
INSURANCE TRUST
INVESTORS LIFE INS. CO.
LABOR UNION
LIBERTY LIFE INS. CO.
LIFE & ACCIDENT INS. CO., THE
LIFE INS. CO.
LINEN SERVICE
MARITIME UNION
MARKETING & ADMINISTRATION
MEDICAL ENTERPRISES
MEDICAL HEALTH CARD SYS.
MOTOR CLUB LIFE & ACCIDENT INS. CO.
OLD LINE INS. CO.
PACIFIC DENTAL
1230-00
1152-00
0325-00
1524-00
0326-00
0327-00
0328-00
2082-00
1320-00
3143-00
1275-00
3417-00
0329-00
0330-00
3238-00
LAM1R032
RUN: 09/24/16 07:28:56
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DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
61
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
NATIONAL
NATIONAL
NATIONAL
NATIONAL
NATIONAL
NATIONAL
NATIONAL
NATIONAL
NATIONAL
NATIONAL
NATIONAL
1502-00
0331-00
0332-00
2286-00
3259-00
3230-00
1834-00
2456-00
0333-00
1297-00
0463-01
2001 MARCUS AVE
POST OFFICE BOX 33999
BOX 1279
1204 LAKE SHORE DR
P O BOX 21240
P O BOX 21240
P O BOX 6249
P O BOX 612
POST OFFICE BOX 1338
P O BOX 15279
NATIONAL EXECUTIVE OFFICE
4850 STREET RD
BOX 7158
STATION C
P O BOX 179
P O BOX 719
1712 MAGNAVOX WAY
P O BOX 2338
POST OFFICE BOX 27321
ATT BENEFITS
P O BOX 23528
P O BOX 802207
NORTHWESTERN PLAZA
SUITE 1010
P O BOX 55284
70 PINE STREET
HEALTH WELFARE FUND
7370 CHEF MENTEUR HWY
P O BOX 4504
112 SOUTH 16TH ST
P O BOX 421169
13650 NW 8TH ST
CENTERPOINT 3 SUITE 172
600 SIX FLAGS DR
ONE NATIONWIDE PLAZA
P O BOX 420
9301 SOUTHWEST FREEWAY
STE. 475
P O BOX 5367
P O BOX 999
2601 W BELTLINE HWY
P O BOX 10136
P O BOX 22625
P O BOX 162145
P O BOX 025680
P O BOX 29059
14800 LANDMARK BLVD
SUITE 700
P O BOX 1220
P O BOX 379020
1000 N CENTRAL EXPRESSWAY
LAKE SUCCESS
SHREVEPORT
TOPEKA
LAKE CHARLES
DENVER
DENVER
LINCOLN
FAIRLAWN
MURFREESBORO
ARLINGTON
TREVOSE
NY
LA
KS
LA
CO
CO
NE
NJ
TN
TX
PA
11042
71130
66601
70601
80221
80221
68506
07410
37130
76015
19049
ATLANTA
GA
30357
HARVEY
HARVEY
FORT WAYNE
LA
LA
IN
70059
70059
46801
ST. LOUIS
HARAHAN
MO
LA
63141
70183
DALLAS
ASHEVILLE
TX
NC
75380
28801
METAIRIE
NEW YORK
NEW ORLEANS
LA
NY
LA
70055
10270
70126
SHREVEPORT
PHILADELPHIA
HOUSTON
SUNRISE
ARLINGTON
LA
PA
TX
FL
TX
71134
19102
77742
33325
76011
COLUMBUS
SPRINGFIELD
HOUSTON
OH
MA
TX
43216
01101
77074
ROCKFORD
APPLETON
MADISON
FAIRFAX
JACKSON
ALTAMONTE SPRINGS
MIAMI
GLENDALE
DALLAS
IL
WI
WI
VA
MS
FL
FL
CA
TX
61125
54912
53713
22030
39255
32716
33102
92109
75240
MERCER ISLAND
LAS VEGAS
DALLAS
WA
NV
TX
98040
89137
75231
RELIGIOUS BRAODCASTERS (SELF-INSURED)
REPUBLIC LIFE INS. CO.
RESERVE LIFE INS. CO.
RISK MANAGEMENT/OWNERS CHOICE
ROOFERS UNION
ROOFERS UNION
RURAL ELECTRIC COOPERATIVE ASSOC
RX
SAVINGS LIFE INS. CO.
SECURITY LIFE & ACCIDENT INS CO
SENIOR CITIZENS GROUP INSURANCE TRUST
NATIONAL SERVICE INDUSTRIES INC
2466-00
NATIONAL SOCIETY OF HEALTH
NATIONAL SOCIETY OF HEALTH
NATIONAL SPORTS UNDERWRITERS
1364-00
1354-00
2397-00
NATIONAL STATES INS. CO.
NATIONAL TEA CO HEALTH & WELFARE PLAN
0334-00
2509-00
NATIONAL TEACHERS ASSOCIATES LIFE INSURANCE CO
NATIONAL TELEPHONE COOPERATIVE ASSOCIATION
2968-00
1216-00
NATIONAL TRESHOLD PLAN
NATIONAL UNION FIRE INS CO OF PITTSBURG PA
NATIONAL UNION OF OPERATORS & ENGINEERS
1730-00
0819-00
1422-00
NATIONAL WASHINGTON INS
NATIONAL-BEN FRANKLIN CO.-VWWI HEALTH INS PLANS
NATIONALWAY HEALTHCARE ASSOCIATION
NATIONS HEALTH
NATIONWIDE GROUP INSURANCE
1867-00
2537-00
3269-00
3217-00
1341-00
NATIONWIDE LIFE INS. CO.
NATIONWIDE LIFE INSURANCE COMPANY
NAVAJO LIFE INS. CO.
0335-00
3470-00
0336-00
NAVISTAR AETNA BENEFITS
NAVITUS HEALTH SOLUTIONS
NAVITUS RX
NCAS (NATIONAL CAPITAL ADMINISTRATIVE SERVICES)
NEEL SCHAFFER INC
NEESE INDUSTRIES INC
NEIGHBORHOOD HEALTH PARTNERSHIP
NESTLE USA GROUP BENEFIT PLANS
NETWORK DENTAL PLAN
1140-00
3944-00
4133-00
2548-00
2782-00
1721-00
2984-00
2499-00
2681-00
NETWORK MANAGEMENT INC
NEVADA CARE
NEW ENGLAND CARE HEALTH PLAN
1133-00
3356-00
2618-00
LAM1R032
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DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
62
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
NEW ENGLAND GENERAL LIFE INS. CO.
NEW ENGLAND INSURANCE CO
0337-00
2016-00
BOSTON
ATLANTA
MA
GA
02117
30346
NEW ENGLAND LIFE
1372-00
TAMPA
FL
33630
NEW
NEW
NEW
NEW
NEW
NEW
ENGLAND MUTUAL LIFE INS. CO., THE
ERA LIFE INS COMPANY
JERSEY LIFE INS. CO.
ORLEANS CHOICE PLAN
ORLEANS ELECTRICAL
ORLEANS ELECTRICAL HEALTH & WELFARE PLAN
0338-00
1955-00
0339-00
2749-00
4109-00
0783-00
BOSTON
HOUSTON
SADDLE BROOK
KENNER
GOODLETTSVILLE
METAIRIE
MA
TX
NJ
LA
TN
LA
02117
77210
07662
70065
37070
70002
NEW ORLEANS EMPLOYERS
NEW ORLEANS ROOFING & WELFARE PLAN LOCAL 141
NEW ORLEANS SHEET METAL WORKERS
3717-00
1676-00
0887-00
NEW ORLEANS
NEW ORLEANS
METAIRIE
LA
LA
LA
70130
70116
70002
NEW
NEW
NEW
NEW
NEW
NEW
NEW
1232-00
1531-00
0805-00
3090-00
1334-00
0340-00
1859-00
501 BOYLSTON STREET
115 PERIMETER CENTER
SUITE 465 WEST
CLAIMS DEPARTMENT
P O BO
501 BOYLSTON STREET
P O BOX 4884
PARK 80 PLAZA WEST
200 WEST ESPLANADE #606
P O BOX 1449
3200 RIDGE LAKE
SUITE 123
147 CARONDELET ST/STE 300
1407 DECATUR STREET
HEALTH AND WELFARE FUND
4400 YALE STREET
2450 SEVERN AVE #517
P O BOX 2469
P O BOX 42576
2624 N 5TH ST
P O BOX 60577
1 MUTUAL OF OMAHA PLAZA
195 BROADWAY
SUITE 8BE
P O BOX 51772
8183 W ELK CALJON
P O BOX 802422
5301 AUGUST AVE
6928 SAINTS AVE
10877 WATSON RD
P O BOX 2310
P O BOX 420
SPRINGFIELD
P O BOX 5087
3510 LINCOLN WAY
P O BOX 1149
346 W17TH ST
POST OFFICE BOX 1447
P O BOX 2291
P O BOX 2291
P O BOX 70100
PO BOX 12170
P O BOX 21734
1833 PLANTSIDE DR
4417 CORPORATION LANE
P O BOX 1984
P O BOX 1984
1015 E. BROAD STREET
P O BOX 44160
10877 WATSON ROAD
P O BOX 94928
METAIRIE
TUSCALOOSA
SAN FRANCISCO
MILES
NEW ORLEANS
OMAHA
NEW YORK
LA
AL
CA
MI
LA
NE
NY
70001
35403
94142
49120
70160
68175
10007
LAFAYETTE
BATON ROUGE
DALLAS
MARRERO
METAIRIE
ST LOUIS
MOUNT CLEMENS
LA
LA
TX
LA
LA
MO
MI
MA
70501
70815
75380
70072
70003
83127
48046
01101
THIBODAUX
AMES
PERU
NEW YORK
CEDAR RAPIDS
MORGAN CITY
MORGAN CITY
SHREVEPORT
OVERLAND PARK
SHREVEPORT
LOUISVILLE
VIRGINIA BEACH
NASHVILLE
NASHVILLE
COLUMBUS
MADDISON
ST. LOUIS
CLEVELAND
LA
IA
IN
NY
IA
LA
LA
LA
KS
LA
KY
VA
TN
TN
OH
WI
MO
OH
70302
50014
46970
10011
52406
70381
70380
71137
66212
71151
40299
23462
37202
37202
43205
53744
63127
44101
ORLEANS STEAMSHIP ASSOCIATION
SOUTHLAND NATIONAL INSURANCE CO
SYSTEMS INC
WORLD CLAIMS SERVICES
YORK LIFE & CHAMBER-NEW ORLEANS GRP CLAIMS OFFICE
YORK LIFE INS. CO., THE
YORK STATE EMPLOYER BENEFITS PROGRAM
NEWPARK RESOURCES INC
NEWTRON GROUP INC
NEXCALIBER
NEXION HEALTH CARE
NFI PLAYERS GROUP INS. PLAN
NFPEDA GROUP INSURANCE TRUST
NGS CORESOURCE
NHP SPECIALTY HEALTH CLAIMS
0761-00
2758-00
3137-00
3243-00
2742-00
0750-00
3878-00
3591-00
NICHOLS STATE INSURANCE
NIPPON LIFE INSURANCE CO. OF AMERICA
NIXON NEWSPAPER'S INC
NMU PENSION TRUST
NN INVESTORS LIFE INS. CO., INC.
NOBLE INSURANCE CO
NOBLE LOWNDES/JOHNSON/SEACOR MARINE INC.
NOE ENTERPRISES, INC
NOMDA GROUP INS. TRUST
NORAM BENEFITS
NORMAL LIFE INC
NORSHIP CO - POS-M/C
NORTH AMERICA ADMINISTRATION
NORTH AMERICA ADMINISTRATORS
NORTH AMERICA EQUITABLE LIFE ASSUR. CO.
NORTH AMERICAN
NORTH AMERICAN BENEFIT ADMINISTRATORS
NORTH AMERICAN BENEFITS NETWORK
2530-00
2835-00
2558-00
0778-00
0315-00
2034-00
2059-00
2777-00
0905-00
2630-00
2322-00
2778-00
2668-00
2372-00
0342-00
4094-00
1792-00
2033-00
LAM1R032
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DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
63
TPL CARRIER FILE LISTING
CARRIER NAME
NORTH
NORTH
NORTH
NORTH
NORTH
NORTH
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
AMERICAN
CO. FOR LIFE AND HEALTH INS.
HEALTH PLANS
INS COMPANY
INS TRUST(AMERICAN HLT NETWORK INC)
LIFE AND CASUALTY CO.
LIFE ASSURANCE CO.
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
0341-00
2974-00
2409-00
1057-00
0344-00
0343-00
POST OFFICE BOX 466
P O BOX 9501
150 EAST GILMAN STREET
P O BOX 32127
1750 HENNEPIN AVENUE
STE. 104
57 RIVER STREET
P O BOX 44160
P O BOX 30025
411 W. CHAPEL HILL ST
MUTUAL PLAZA
BOX 43139
P O BOX 90802
P O BOX 167768
P O BOX 901
P O BOX 17258
ALLSTATE PLAZA
P O BOX 21240
P O BOX 7676
POST OFFICE BOX 12530
4230 LBJ FREEWAY -STE 204
2323 EASTLAKE AVE
P O BOX 279
P O BOX 951
720 E. WISCONSIN AVENUE
20 WASHINGTON AVE S
600 OAKBROOK
206 8TH ST
P O BOX 308
P O BOX 25330
P O BOX 890097
P O BOX 3100
P O BOX 4100
P O BOX 6249
CLAIMS FILING
1448 DUKE ST
POST OFFICE BOX 402207
1 PACK SQUARE
SUITE 600
550 12TH ST SW
ESG MANUFACTURING
30070 DAN PIERSON RD
2449 WEST PARE AVENUE
21 E WASHINGTON ST
SUITE 715
98 SAN JACINTO BLVD
3301 WEST AIRPORT FWY
SUITE 12
P O BOX 300
1515 POYDRAS ST.
SUITE 2000
CHICAGO
AMHERST
MADISON
PHOENIX
MINNEAPOLIS
WELLESLEY HILLS
IL
NY
WI
AZ
MN
MA
60690
14226
53703
85064
55403
02181
MADISON
DURHAM
DURHAM
WI
NC
NC
53744
27702
27701
ST. PAUL
LUBBOCK
IRVING
SPRINGHILL
WINSTON-SALEM
NORTHBROOK
DENVER
ST CLAIR SHORES
SEATTLE
DALLAS
SEATTLE
THIBODEAUX
BATON ROUGE
MILWAUKEE
MINNEAPOLIS
NORCROSS
DES MOINES
GRAND ISLAND
LITTLE ROCK
CAMP HILL
MECHANICSBURG
CAROL STREAM
LINCOLN
MN
TX
TX
LA
NC
IL
CO
MI
WA
TX
WA
LA
LA
WI
MN
GA
IA
NY
AR
PA
PA
IL
NE
55164
79408
75016
71075
27116
60062
80221
48080
98111
75244
98102
70301
70821
53202
55440
30093
50309
14072
72221
17089
17055
60197
68506
ALEXANDRIA
DALLAS
ASHVILLE
VA
TX
NC
22314
75240
28801
WASHINGTON
HOLDEN
DC
LA
20065
70744
GRAY
CHICAGO
LA
IL
70359
60602
AUSTIN
BEDFORD
TX
TX
78701
76021
TULSA
NEW ORLEANS
OK
LA
74102
70112
NORTH AMERICAN SUPPLEMENT INS
NORTH CAROLINA COMPREHENSIVE STATE HEALTH PLAN
NORTH CAROLINA MUTUAL LIFE INS. CO.
3879-00
1858-00
0346-00
NORTH CENTRAL LIFE INS. CO.
NORTH OAKS HEALTH SYSTEM
NORTH TEXAS HEALTH CARE
NORTH WEBSTER MEDICAL SERVICE
NORTHBROOK INS CO
NORTHBROOK LIFE INS. CO.
NORTHERN COLORADO ROOFERS HEALTH AND WELFARE
NORTHERN GROUP SERVICES INC
NORTHERN LIFE INS. CO.
NORTHROP HEALTH CARE PLAN
NORTHWEST ADMINISTRATORS INC
NORTHWESTERN LIFE INSURANCE
NORTHWESTERN MUTUAL LIFE INS.
NORTHWESTERN MUTUAL LIFE INS. CO., THE
NORTHWESTERN NATIONAL LIFE INS. CO.
NORTHWESTERN NATIONAL LIFE OF GA
NORWEST FINANCIAL INC
NOVA HEALTH CARE ADMINISTRATORS
NOVA SYSTEM HEALTH
NOVITAS
NOVITAS SOLUTIONS, INC
NRA CANCER CARE
NRECA (NATIONAL RURAL ELECTRIC COOPERATION ASSOC)
0347-00
3284-00
2677-00
1952-00
1056-00
0345-00
2139-00
0884-00
0348-00
0998-00
1679-00
1569-00
1911-00
0349-00
0350-00
2478-00
2129-00
2597-00
3966-00
4029-00
4032-00
2857-00
0753-00
NRLCA ASSOCIATE HOSPITAL PLAN
NTA LIFE INS. CO.
NTCA
1201-00
0316-00
3697-00
NTEU
NUMANCO L.L.C.
2119-00
2971-00
NVI, LLC
NWNL GROUP
4096-00
1550-00
NYLACOR
OAK TREE ADMINISTATORS INC
2836-00
1795-00
OCCIDENTAL COMPREHENSIVE MEDICAL PLAN
OCCIDENTAL HEALTH INS. CO. OF NEW ORLEANS
1235-00
0517-00
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
64
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
OCCIDENTAL LIFE INS. CO. OF NC
0351-00
RALEIGH
NC
27605
OCHSNER HEALTH PLAN
ODS HEALTH PLAN
OFF SHORE LOGISTICS (AIR LOGISTICS)
OFFICE DEPOT HEALTH PLAN
OFFICE OF GROUP BENEFITS
OHIO CASUALTY INSURANCE CO.
OHIO NATIONAL LIFE ASSURANCE CORP.
OHIO NATIONAL LIFE INS. CO., THE
OHIO STATE LIFE INS. CO., THE
OHMSTEDE INC
OKLAHOMA NATIONAL LIFE INS. CO.
0841-00
3240-00
1409-00
2776-00
3531-00
1585-00
0352-00
0353-00
0354-00
2116-00
0355-00
LEXINGTON
PORTLAND
LAFAYETTE
LITTLE ROCK
BATON ROUGE
HAMILTON
CINCINNATI
CINCINNATI
COLUMBUS
JACKSON
IRVING
KY
OR
LA
AR
LA
OH
OH
OH
OH
MN
TX
40512
97208
70505
72203
70804
45012
45201
45201
43216
56143
75062
OLD AMERICAN INS. CO.
OLD DOMINION FREIGHT LINE,INC.
OLD REPUBLIC LIFE INS. CO.
OLD SOUTHERN LIFE INS. CO.
OLD SURETY LIFE INSURANCE CO
OLIN DIRECT CLAIMS SERVICE (SELF-INSURED)
OLOL REGIONAL MEDICAL CENTER (SELF-INSURED)
OLYMPIC HEALTH MANAGEMENT SYSTEMS INC
OMAHA FINANICAL LIFE INS. CO.
OMEGA SERVICE
OMNI CARE HEALTH PLAN
OMNI GROUP
OMNI-TRUST
ONE CARE BY CARE FIRST ARIZONA
0356-00
2747-00
0357-00
0358-00
2017-00
1166-00
2552-00
2933-00
0359-00
2281-00
2087-00
1901-00
1928-00
H543-00
KANSAS CITY
WINSTON SALEM
CHICAGO
MONTGOMERY
OKLAHOMA CITY
STRATFORD
BATON ROUGE
BELLINGHAM
ST. PAUL
NEW IBERIA
DETROIT
BATON ROUGE
NASHVILLE
PHOENIX
MO
NC
IL
AL
OK
CT
LA
WA
MN
LA
MI
LA
TN
AZ
64111
27114
60601
36102
73154
06497
70808
98227
55111
70562
48202
70896
37202
85016
ONE HEALTH PLAN
ONE NET
ONE SOURCE ADMINISTRATORS
3111-00
3921-00
2917-00
FORT SCOTT
FREDERICK
LAFAYETTE
KS
MD
LA
66701
21705
70508
OPASTCO
1380-00
DALLAS
TX
75379
OPELOUSAS GEN HOSPITAL GROUP HEALTH BENEFIT PLAN
OPERATING ENGINEERS HEALTH & WELFARE FUND
OPTIMA HEALTH
OPTIMED HELATH PLANS
OPTIMRX
OPTUM HEALTH
OPTUM RX
ORANGE STATE LIFE AND HEALTH INS. CO.
OREGON DENTAL SERVICE
ORLEANS LEVEE BOARD
1101-00
1284-00
3759-00
3577-00
4021-00
3862-00
4131-00
0360-00
2823-00
0879-00
OPELOUSAS
PASADENA
TROY
NEWTOWN
HOT SPRINGS
SALT LAKE CITY
IRVINE
LARGO
PORTLAND
NEW ORLEANS
LA
CA
MI
PA
AR
UT
CA
FL
OR
LA
70570
71109
48007
18940
71903
84130
92614
33540
97240
70126
ORLEANS PARISH SCH.BRD.EMP.GRP HEALTH BENF.PGRM
1262-00
NEW ORLEANS
LA
70190
ORNDA HEALTH CORP
ORYX
OSCAR MAYER
2828-00
3027-00
2255-00
POST OFFICE BOX 10234
CAMERON VILLAGE
P O BOX 14601
P O BOX 4030
P O BOX 53178
P O BOX 8074
P O BOX 44036
136 NORTH THIRD ST
POST OFFICE BOX 237
POST OFFICE BOX 237
POST OFFICE BOX 910
146 INDUSTRIAL PARK
4545 FULLER DRIVE
STE. 230
3520 BROADWAY
P O BOX 25307
307 N. MICHIGAN AVENUE
POST OFFICE DRAWER 911
P O BOX 54407
150 LONG BEACH BLVD
7777 HENNESSEY BLVD
P O BOX 5348
POST OFFICE BOX 1711
P O BOX 14338
7650 SECOND AVE
P O BOX 66635
DRAWER T-393
2355 E CAMELBACK ROAD
STE 300
P O BOX 11111
P O BOX 934
1720 KALISTE SALOOM RD
SUITE C7
DIVERSIFIED CONSULTANTS
P O BOX 792128
P O BOX 1208
P O BOX 7067
P O BOX 5028
4 TERRY ROAD
P O BOX 29044
P O BOX 30758
2300 MAIN ST
2400 WEST BAY DRIVE
P O BOX 40384
ADMINISTRATION BLDG
STE.201 LAKEFRONT AIRPORT
PARKER PLEAS BROWN/DAVIS
P O BOX 30176
P O BOX 8097
P O BOX 690450
P O BOX 7188
LONDON
SAN ANTONIO
MADISON
KY
TX
WI
40742
78269
53707
LAM1R032
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DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
65
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
OTIS ENGINEERING CORP. GROUP BENEFITS PROGRAM
OUACHITA NATIONAL BANK
OUR LADY OF LOURDES REGIONAL MEDICAL CENTER
OUR LADY OF THE LAKE RMC
OUTSIDE ELECTRICAL WELFARE FUND
OXFORD FREEDOM PLAN
OXFORD LIFE INS. CO.
OXFORD MEDICARE COMPLETE
OZARK NATIONAL LIFE INS. CO.
P F L LIFE INSURANCE COMPANY
P FIVE ELECTRONIC HEALTH SERVICES
P-FIVE ELECTRIC HEALTH SERVICES
PA HEAVY & HIGHWAY CONTRACTORS WELFARE PLAN
PACC HEALTH PLAN
PACE GREATER OF NEW ORLEANS
PACIFIC CARE OF CALIFORNIA
PACIFIC CARE OF TEXAS
PACIFIC FIDELITY LIFE INS. CO.
PACIFIC HERITAGE ASSURANCE
PACIFIC MUTUAL BENEFIT
PACIFIC MUTUAL BENEFITS
PACIFIC MUTUAL GROUP
1846-00
0915-00
1720-00
2643-00
2637-00
2786-00
1571-00
H310-70
0361-00
2101-00
3148-00
3380-00
2267-00
2258-00
3934-00
2100-00
2845-00
0362-00
0982-00
1829-00
0018-29
2003-00
DUNCAN
MONROE
LAFAYETTE
BATON ROUGE
HUNTINGTON
NORWALK
PHOENIX
BRIDGEPORT
KANSAS CITY
LITTLE ROCK
SALT LAKE CITY
SALT LAKE CITY
HARRISBURG
CLACKAMAS
CINCINNATI
CYPRESS
SAN ANTONIO
CEDAR RAPIDS
PORTLAND
COVINGTON
COVINGTON
FORT WRIGHT
OK
LA
LA
LA
WV
CT
AZ
CT
MO
AR
UT
UT
PA
OR
OH
CA
TX
IA
OR
KY
KY
KY
73534
71201
70502
70898
25729
06856
85004
06601
64016
72203
84109
84109
17112
97015
45206
90630
76265
52499
97207
41016
41016
41011
PACIFIC MUTUAL LIFE INS. CO.
PACIFIC SOURCE HEALTH PLANS
PACIFIC STANDARD LIFE INS. CO.
PACIFICARE
PACIFICARE LIFE
0363-00
2671-00
0364-00
2972-00
H543-50
NEWPORT BEACH
EUGENE
SACRAMENTO
COLORADO SPRINGS
SAN ANTONIO
CA
OR
CA
CO
TX
92660
97401
95808
80935
78265
PACIFICARE OF TEXAS
H459-00
SAN ANTONIO
TX
78230
PAID DENTAL
PAID PRESCRIPTIONS,INC
PAINTERS DISTRICT COUNCIL
2569-00
1317-00
2592-00
AUSTIN
FAIR LAWN
WALLINGFORD
TX
NJ
CT
78766
07410
06432
PAINTERS-PAPERHANGERS-LU1244 H & W
1916-00
ATLANTA
GA
30345
PALMETTO GBA
PAN AMERICAN
PAN AMERICAN LIFE
PAN ENERGY CORP
PAN-AMERICAN LIFE INS. CO.
PANAMA CANAL HEALTH INS
3940-00
4042-00
3865-00
2876-00
0365-00
1325-00
COLUMBUS
EL PASO
LUBBOCK
HOUSTON
NEW ORLEANS
APO MIAMI
OH
TX
TX
TX
LA
FL
43218
79998
79490
77251
70160
34011
PANHANDLE EASTERN INS. CO.
PARACELSUS HEALTH CARE CORP (SELF-INSURED)
0824-00
2392-00
HOUSTON
PASADENA
TX
CA
77027
91101
PARAGON BENEFITS INC
PARAMOUNT LIFE INS. CO.
PARAMOUNT-SECURITY LIFE INS. CO.
PARISH GOV RISK MANAGEMENT AGENCY-GROUP HEALTH
3087-00
0366-00
0367-00
0731-00
P O BOX 6000
P O BOX 1412
611 ST LANDRY
5000 HENNESSY BLVD
P O BOX 2967
P O BOX 5031
2721 NORTH CENTRAL AVE
P O BOX 7082
906 GRAND AVENUE
P O BOX 2900
P O BOX 9554
P O BOX 9554
P O BOX 6250
P O BOX 286
619 OAK ST
P O BOX 6006
8200 IH 10 WEST
POST OFFICE BOX 1447
P O BOX 1020
P O BOX 16190
P O BOX 16190
LOOKOUT CORPORATE CENTER
1717 DIXIE HWY/STE 700
700 NEWPORT CENTER DRIVE
P O BOX 7068
POST OFFICE BOX 1796
P O BOX 15180
SECURE HORIZONS DIRECT
P O BOX 659787
8200 IH-10
STE 1000
P O BOX 9201
1900 POLLITT DR
NO 11 HEALTH FUND
P O BOX 5817
2300 HENDERSON
MILL RD #414
P O BOX 182932
P O BOX 981644
P O BOX 99007
P O BOX 1642
POST OFFICE BOX 60219
PANAMA CANAL AREA BENEFIT
GROUP INS BOARD
5005 RIVERWAY
155 N LAKE AVE
SUITE 1100
P O BOX 1526
POST OFFICE BOX 710
1525 LINE AVENUE
320 SOUTH IBERIA ST
DOUGLASVILLE
LITTLE ROCK
SHREVEPORT
NEW IBERIA
GA
AR
LA
LA
30133
72203
71101
70560
LAM1R032
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DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
66
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
PARISH GOVERNMENT RISK MANAGEMENT
0960-00
BATON ROUGE
LA
70898
PARISH GOVERNMENT RISK MANAGEMENT
PARKER DRILLING CO GROUP HEALTH
3899-00
3376-00
METAIRIE
HOUSTON
LA
TX
70009
77077
PARTNERS HEALTH PLAN OF LOUISIANA
1752-00
METAIRIE
LA
70002
PARTNERS INSURANCE CO
PARTNERS NATIONAL HEALTH PLAN
PARTNERSHIP HEALTH PLAN OF CA
PASSPORT ADVANTAGE
PAT HANEY & SON
PATCO ASSURANCE CO
PATIENT'S CHOICE
1254-00
1546-00
3924-00
3614-00
2204-00
2571-00
2931-00
IRVING
MEMPHIS
SUISUN
HATTIESBURG
DALLAS
BOSSIER CITY
BATON ROUGE
TX
TN
CA
PA
TX
LA
LA
75015
38187
94585
17106
75236
71111
70816
PATIENT'S COMPENSATION FUND
PAUL M. DAVISON PETRO PRODUCTS
PAUL REVERE LIFE INS. CO., THE
PAYFLEX SYSTEMS, USA
PAYLESS CASHWAYS BENEFIT PLAN
PBP HEALTH PLAN
PCA SOLUTIONS INC
PCS INCORPORATION (PHARMACEUTICAL CARD SYSTEM)
PEARL REAL ESTATE TRUST
PEERLESS INSURANCE COMPANY
3176-00
1037-00
0368-00
1604-00
2759-00
3195-00
2766-00
1356-00
2746-00
1009-00
BATON ROUGE
RUSHTON
WORCESTER
OMAHA
KANSAS CITY
SAN ANTONIO
BATON ROUGE
PHOENIX
PEORIA
KEENE
LA
LA
MA
NE
MO
TX
LA
AZ
IL
NH
70821
71270
01608
68131
64141
78278
70898
85072
61614
03431
PEKIN LIFE INSURANCE COMPANY
PEN WEL INC
PENINSULAR LIFE INS. CO.
PENN CARE PLUS
PENN GENERAL SERVICES OF GA.
PENN LIFE INS CO
2293-00
2500-00
0369-00
1540-00
1260-00
1332-00
PEKIN
PITTSBURGH
JACKSONVILLE
HOUSTON
ATLANTA
SHAWNEE MISSION
IL
PA
FL
TX
GA
KS
61558
15250
32204
77282
30358
66201
PENN MUTUAL LIFE INS. CO., THE
PENN TREATY NETWORK
PENNINGTON ENTERPRISES INC
PENNSYLVANIA EMPLOYEE BENEFIT TRUST FUND
0370-00
3706-00
2209-00
2015-00
PHILADELPHIA
PENSACOLA
HAMMOND
HARRISBURG
PA
FL
LA
PA
19105
32591
70404
17101
PENNSYLVANIA LIFE INS. CO.
PENSION & GROUP SERVICES INC
PENSION ASSOCIATES INC
PENSION LIFE INS. CO. OF AMERICA
PENSION SERVICES IND
PEOPLE HEALTH
PEOPLE'S HEALTH
PEOPLE'S HEALTH NETWORK
0371-00
1965-00
1785-00
0372-00
1619-00
4004-00
H060-00
2682-00
SANTA MONICA
KALAMAZOO
ST LOUIS
VALLEY FORGE
NEW ORLEANS
METAIRIE
METAIRIE
METAIRIE
CA
MI
MO
PA
LA
LA
LA
LA
90406
49003
63127
19482
70116
70010
70010
70005
PEOPLES (PROVIDIAN) BENEFIT LIFE INS. CO.
2722-00
VALLEY FORGE
PA
19482
PEOPLES HEALTH
PEOPLES HEALTH
H196-10
3561-00
CONCORDIA PARK
PO BOX 80297
P O BOX 6794
1401 ENCLAVE PARKWAY
STE 600
3838 N CAUSEWAY BLVD
SUITE 1919
P O BOX 152280
P O BOX 171823
P O BOX 610
P O BOX 69325
P O BOX 670602
P O BOX 5382
3029 S SHERWOOD FOREST BL
SUITE 200
P O BOX 3718
P O DRAWER 310
18 CHESTNUT STREET
200 BLACKSTONE CENTRE
P O BOX 419973
P O BOX 782369
P O BOX 80297
P O BOX 52115
1200 EAST GLEN AVENUE
62 MAPLE AVENUE
INSURANCE BUILDING
2505 COURT ST
P O BOX 371969
645 RIVERSIDE AVENUE
P O BOX 820969
P O BOX 720677
AM TRUST ADM INC
P O BOX 87
530 WALNUT STREET
P O BOX 130
P O BOX 819
5TH FLOOR CITY TOWERS
301 CHESTNUT STREET
3130 WILSHIRE BOULEVARD
P O BOX 4022
3701 S LINDBERGH
POST OFFICE BOX 807
1407 DECATUR ST
P O BOX 7890
P O BOX 7890
111 VETERANS BLVD
SUITE 1424
CLAIMS SERVICE DIVISION
P O BOX 1343
P O BOX 7890
3838 N CAUSEWAY BLVD
SUITE 2200
METAIRIE
METAIRIE
LA
LA
70010
70002
LAM1R032
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DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
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TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
PEOPLES HEALTH PPO
H550-10
METAIRIE
LA
70002
PEOPLES LIFE INS. CO. OF S.C.
PEQUOT HEALTH CARE
1695-00
3764-00
GREENVILLE
MASHANTUCKET
SC
CT
29609
06339
PERCS
PERFORMAX
PERRET-DOISE, LAW FIRM -EMPLOYEE BENEFIT SRVCS
PERSONAL CARE
PERSONAL LIFE INSURANCE CO.
PERSONNEL RISK MANAGEMENT
PETROLEUM EQUIPMENT TOOLS COMPANY
2724-00
1940-60
2650-00
3650-00
0373-00
2487-00
2178-00
LOS VEGAS
KING OF PRUSSIA
SHREVEPORT
LONDON
ENID
HOUSTON
HOUSTON
NV
PA
LA
KY
OK
TX
TX
89109
19406
71137
40742
73701
77060
77227
PETROLEUM GEO-SERVICES INC
PHARMACARE
PHARMACY ASSOCIATES
PHCS
PHCS
PHILADELPHIA AMERICAN
PHILADELPHIA AMERICAN
PHILADELPHIA AMERICAN LIFE INSURANCE CO
PHILLIPS ADMINISTRATIVE SERVICE INC
PHILLIPS MEDICAL DENTAL PLAN
PHOENIX HOME LIFE INS.
PHOENIX MUTUAL LIFE INS. CO.
PHP OF TENNESSEE INC
PHYSICIAN ALLIANCE
PHYSICIANS CORPORATION OF AMERICA (PCA)
PHYSICIANS HEALTH PLAN
PHYSICIANS LIABILITY INSURANCE COMPANY
PHYSICIANS LIFE INSURANCE
PHYSICIANS MANAGED CARE
PHYSICIANS MUTUAL INSURANCE CO
PHYSICIANS MUTUAL INSURANCE CO
PIAS OF LOUISIANA BENEFIT TRUST
PICCADILLY HEALTH INS
PICKETT FOOD SERVICES INCORP
PIEDMONT AMERICAN LIFE
PILGRIM LIFE INS. CO. OF AMERICA
PILGRIMS PRIDE CORP. (SELF-INSURED)
PILOT LIFE INS. CO.
PINNACLE HEALTH CLAIMS MANAGEMENT
3600-00
3277-00
2521-00
3590-00
4085-00
0375-00
0374-00
0848-00
2076-00
2632-00
2534-00
0376-00
3245-00
H126-40
2657-00
1205-00
2765-00
3810-00
2948-00
3737-00
0377-00
1509-00
1500-00
1066-00
0851-00
0378-00
2505-00
0379-00
3182-00
SAN ANTONIO
PITTSBURGH
LITTLE ROCK
NEW ORLEANS
CLITON
HOUSTON
HOUSTON
HOUSTON
ALBANY
ARLINGTON
AGAWAM
HARTFORD
KNOXIVLLE
BATON ROUGE
SAN ANTONIO
SHREVEPORT
OKLAHOMA CITY
OMAHA
NORTHBROOK
OMAHA
OMAHA
NASHVILLE
BATON ROUGE
SHREVEPORT
WINSTON-SALEM
KING OF PRUSSIA
HUNTINGTON BEACH
GREENSBORO
MINDEN
TX
PA
AR
LA
IA
TX
TX
TX
OR
TX
MA
CT
TN
LA
TX
LA
OK
NE
IL
NE
NE
TN
LA
LA
NC
PA
CA
NC
NV
78269
15230
72221
70163
52733
77252
77252
77001
97321
76015
01001
06115
37932
70884
78265
71133
73126
68103
60062
68103
68131
37212
70816
71104
27116
19406
92647
27420
89423
PIONEER ADMINISTRATIVE SERVICES
PIONEER BANK & TRUST CO
PIONEER LIFE
PIONEER LIFE INS. CO. OF IL
PIONEER MUTUAL LIFE INS. CO.
PIONEER TELEPHONE COOPERATIVE
PIPEFITTER'S LOCAL UNION #195 HEALTH & WELFARE FUND
PIPEFITTERS LOCAL 597 WELFARE FUND
3790-00
2633-00
1874-00
0380-00
0381-00
2186-00
1914-00
2197-00
3838 CAUSEWAY BLVD
STE 2200
1300 RUTHERFORD RD
P O BOX 3620
BUILDING 3
2950 S INDUSTRIAL RD
P O BOX 61505
P O BOX 70100
P O BOX 7141
POST OFFICE BOX 1746
411 N BELT E #330
P O BOX 27706
ATTN: INSURANCE DEPT
P O BOX 690450
P O BOX 2860
P O BOX 2307
1100 POYDRAS ST/STE 2600
P O BOX 2806
P O BOX 2927
P O BOX 2465
PO BOX 2465
P O BOX 218
P O BOX 91555
P O BOX 3005
ONE AMERICAN ROW
1420 CENTERPOINT BLVD
P O BOX 83179
P O BOX 659515
P O BOX 37870
P O BOX 26727
P O BOX 3313
609 ACADEMY DR
P O BOX 2018
2600 DODGE ST
P O BOX 120539
3232 S SHERWOOD FOREST BL
3811 GILBERT AVE
P O BOX 11107
550 WEST DEKALB PIKE
P O BOX 3239
POST OFFICE 20727
2248 MERIDIAN BLVD
SUITE B
P O BOX 186
P O BOX 52868
P O BOX 619077
127-129 N WYMAN ST
203 NORTH 10TH STREET
P O BOX 839
P O DRAWER C
45 N OGDEN DR
SYRACUSE
SHREVEPORT
DALLAS
ROCKFORD
FARGO
KINGFISHER
NEDERLAND
CHICAGO
NY
LA
TX
IL
ND
OK
TX
IL
13206
71135
75261
61101
58102
70760
77627
60607
LAM1R032
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DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
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TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
PIPELINE INDUSTRY BENEFIT FUND
PIPETRADES HEALTH AND WELFARE PLAN
PIRELLI ARMSTRONG TIRE CORP
PITTMAN & ASSOCIATES
PIZZA HUT CLAIMS
PLAINS ALL AMERICAN
PLAN ADMINSTRATOR
PLAN AMERICAN LIFE INSURANCE
PLAN SERVICES
PLANNED ADMINISTRATORS
PLANNED ADMINISTRATORS INC
PLANNED BENEFIT SERVICE
PLATINUM SAFETY AND CLAIMS SERVICES
PLAYER'S CASINO
PLUM CREEK
PLUMBERS & FITTERS LOCAL 514
PLUMBERS & STEAM FITTERS LOCAL #60
PLUMBERS & STEAMFITTERS
PLUMBERS & STEAMFITTERS
PLUMBERS & STEAMFITTERS HEALTH & WELFARE PLAN
PLUMBERS & STEAMFITTERS LOCAL #760
PLUMBERS & STEAMFITTERS UNION, LOCAL 141
1104-00
0769-00
3332-00
2709-00
2584-00
2998-00
1983-00
2851-00
0748-00
1491-00
3572-00
1288-00
3128-00
2732-00
2865-00
2764-00
0785-00
3755-00
2070-00
0861-00
1898-00
0901-00
TULSA
TERRE HAUTE
GOODLETTSVILLE
MEMPHIS
COLUMBIA
HOUSTON
RIDGELAND
NEW ORLEANS
TAMPA
CORPUS CHRISTI
COLUMBIA
SCOTTSDALE
TYLER
LAKE CHARLES
MINNEAPOLIS
WARRENVILLE
METAIRIE
BUCKEYTOWN
PINEVILLE
MONROE
MUSCLE SHOALS
SHREVEPORT
OK
IN
TN
TN
SC
TX
MS
LA
FL
TX
SC
AZ
TX
LA
MN
IL
LA
MD
LA
LA
AL
LA
74147
47803
37070
38111
29224
77210
39158
70130
33630
78404
29260
85252
75711
70601
55440
60555
70002
21717
71360
71203
35662
71129
PLUMBERS AND STEAMFITTERS LOCAL 106
PLYMOUTH TUBE CO.INS
POLARIS BENEFIT ADMINISTRATORS
POLYCHROME CORP
POMCO
POOL CO INS
POSITIVE CARE
POSTAL SUPERVISORS HEALTH BENEFIT PLAN
POSTAL WORKER UNION
POSTMASTERS BENEFIT PLAN
PPG INDUSTRIES INC INDUSTRIAL CHEMICAL DIV
PPO NEXT
PPO PLUS
PPO PLUS
PPO-NEXT C/O NATIONAL CARE NETWORK
0994-00
0941-00
2970-00
2605-00
2923-00
1290-00
2533-00
1660-00
3400-00
0870-00
0729-00
3365-00
3150-00
4087-00
3508-00
LAKE CHARLES
WEST MONROE
DELAWARE
GLEN COVE
SYRACUSE
HOUSTON
SHAWNEE MISSION
ROCKVILLE
HARRISBURG
ALEXANDRIA
LAKE CHARLES
DALLAS
LUBBOCK
OAK BROOK
IRVING
LA
LA
OH
NY
NY
TX
KS
MD
PA
VA
LA
TX
TX
IL
TX
70601
71291
43015
11542
13217
77210
66207
20850
17105
22314
70601
75354
79408
60522
75039
PRAETORIAN MUTUAL LIFE INS. CO.
PRAIRIE STATES LIFE INS. CO.
PRECISE BENEFITS ADMINISTRATORS
PREFERRED BENEFIT ADMINISTRATORS
PREFERRED CARE
PREFERRED CARE INC
PREFERRED CARE OF CAROLINA'S INC
PREFERRED COMMUNITY CHOICE PPO
PREFERRED HEALTH ALLIANCE CORP
PREFERRED HEALTH CARE LIMITED
0382-00
0383-00
3173-00
3098-00
0032-71
3802-00
2117-00
2854-00
3287-00
2320-00
DALLAS
RAPID CITY
JERICHO
LONGWOOD
FT WASHINGTON
FREDERICK
CHARLOTTE
TULSA
BIRMINGHAM
TAMPA
TX
SD
NY
FL
PA
MD
NC
OK
AL
FL
75221
57709
11753
32791
19034
21702
28220
74101
35238
33607
PREFERRED LIFE INS. CO.
0384-00
P O BOX 470950
P O BOX 3040
P O BOX 1449
P O BOX 111047
P O BOX 23759
P O BOX 4648
P O DRAWER 958
147 CARONDELET ST
P O BOX 30078
3104 S ALEMEDA
P O BOX 6702
P O BOX 8883
P O BOX 6367
800 BILBO ST
P O BOX 1195
30W 160 CALUMET AVE
3515 I10 SERVICE RD
P O BOX 845
701 MAIN ST
PO BOX 4617
P O BOX 2567
HEALTH & WELFARE
7113 W BERT KOUNS IND.LP
822 N LAKESHORE
601 GRANTHAM AVE
P O BOX 1008
50 GLEN ST
P O BOX 6329
P O BOX 4271
P O BOX 7930
P O BOX 6093
P O BOX 069025
1019 W ROYAL ST
P O BOX 1000
P O BOX 549023
P O BOX 90802
P O BOX 3428
222 WEST LAS COLINAS BLVD
STE 1500 MILLENIUM CTR
POST OFFICE BOX 419
POST OFFICE BOX 1736
P O BOX 9064
P O BOX 916188
1300 VIRGINIA DR/STE 315
P O BOX 1325
P O BOX 11700
P O BOX 3270
P O BOX 382048
1715 NORTHWEST SHORE BLVD
SUITE 775
POST OFFICE BOX 1231
MONTGOMERY
AL
36192
LAM1R032
RUN: 09/24/16 07:28:56
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DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
69
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
PREFERRED MEDICAL PROVIDERS INC
PREFERRED PLAN OF GEORGIA
PREFERRED RISK LIFE INS. CO.
PREMERA BLUE CROSS
PREMIER BANK CORPORTATION
PREMIER EYE CARE
2627-00
1791-00
0385-00
4132-00
1738-00
4050-00
BAY ST LOUIS
NORCROSS
WEST DES MOINES
MOUNTLAKE TERRACE
SHREVEPORT
DELRAY BEACH
MS
GA
IA
WA
LA
LA
39520
30091
50265
98043
71135
33445
PREMIER NETWORK
PREMIERE LIFE INS. CO.
PREPAID HEALTH PLAN
PRESBYTERIAN CHURCH
PRESCRIPTION SOLUTION
PRESCRIPTION SOLUTIONS
PRESCRIPTION SYSTEM DELIVERY INC
PRESIDENTIAL LIFE INSURANCE
PRI-MED
PRIMARY CARE NETWORK
PRIMARY PHYSICIAN CARE
PRIMARY SELECT
PRIMARY SELECT
PRIME THERAPEUTICS
PRIMERICA
PRINCIPAL
PRINCIPAL FINANCIAL GROUP
PRINCIPAL HEALTH CARE
PRINCIPAL HEALTH CARE OF INDIANA
PRINCIPAL HEALTH CARE OF LOUISIANA
PRINCIPAL LIFE INSURANCE
PRINCIPAL LIFE INSURANCE CO
2251-00
0386-00
2464-00
2644-00
3418-00
3395-00
1542-00
1864-00
0882-00
2370-00
3476-00
3016-00
0030-16
3396-00
2220-00
3515-00
1117-00
2411-00
3018-00
1517-00
3660-00
3066-00
JACKSON
SHREVEPORT
BALDWINSVILLE
PHILADELPHIA
SAN DIEGO
SAN DIEGO
HATBORO
DALLAS
MEMPHIS
LITTLE ROCK
CHARLOTTE
CHARLOTTESVILLE
CHARLOTTESVILLE
SAINT PAUL
DULUTH
COLORADO SPRINGS
HOUSTON
SAN ANTONIO
INDIANAPOLIS
METAIRIE
COLORADO SPRINGS
BATON ROUGE
MN
LA
NY
PA
CA
CA
PA
TX
TN
AR
NC
VA
VA
MN
GA
CO
TX
TX
IN
LA
CO
LA
56143
71130
13027
19101
92150
92150
19040
75228
38187
72203
28220
22902
22902
55164
30990
80949
77096
78279
46204
70011
80949
70808
PRINCIPAL MUTUAL LIFE
PRINTING INDUSTRY ASSOCIATION OF THE SOUTH
PRIORITY HEALTH
PRIVATE AMERICAN INSURANCE COMPANY
PRIVATE HEALTH CARE SYSTEMS/ALC
1127-00
2450-00
3857-00
1746-00
1854-00
DES MOINES
NASHVILLE
GRAND RAPIDS
WACO
NEW ORLEANS
IA
TN
MI
TX
LA
50309
37229
49501
76702
70163
PRIVATE HEALTHCARE SYSTEMS
PRO-AMERIA INSURANCE
PRO-CLAIM PLUS, INC.
PRO-MARK
PROCARE RX
PRODUCERS EXCHANGE BENEFIT SERVICES INC.
3509-00
2829-00
3191-00
2891-00
1000-95
2545-00
HENDERSONVILLE
FT.WORTH
FORT WAYNE
PEACE DALE
MIRAMAR
IRVING
TN
TX
IN
RI
FL
TX
37077
76101
46899
02883
33025
75038
PRODUCTION MANAGEMENT COMPANIES INC
PROFESSIONAL ADMINISTRATION GROUP
2222-00
2085-00
HARVEY
OVERLAND PARK
LA
KS
70059
66212
PROFESSIONAL
PROFESSIONAL
PROFESSIONAL
PROFESSIONAL
PROFESSIONAL
2468-00
1538-00
2400-00
0387-00
0388-00
P O BOX 65
P O BOX 6450
1111 ASHWORTH ROAD
7001 220TH ST SW BUILDI
P O BOX 51005
4205 W ATLANTIC AVE
BLDG D
146 INDUSTRIAL PARK
POST OFFICE BOX 33999
8278 WILLETT PKWY
P O BOX 13896
P O BOX 509075
P O BOX 509075
BOX 340
8035 ERL THORTON EXPWY
P O BOX 171816
P O BOX 8002
P O BOX 11088
P O BOX 1323
P O BOX 323
P O BOX 64812
3120 BRECKINRIDGE BLVD
P O BOX 39710
10103 FONDREN SUITE 500
P O BOX 795014
1 NORTH PENNSYLVANIA ST
P O BOX 8175
P O BOX 39710
2431 S ACAIDAN THRUWAY
SUITE 290
711 HIGH ST
P O BOX 290249
P O BOX 232
P O BOX 2650
1100 POYDRAS ST
STE 2600
P O BOX 1439
P O BOX 901037
P O BOX 9648
P O BOX 3704
3891 COMMERCE PKWY
5525 MACARTHUR BLVD
SUITE 350
P O BOX 44
P O BOX 13390
8500 W 110TH ST/STE 650
201 E OGDEN AVE/STE 120
10835 ROCKLEY ROAD
P O BOX 35276
135 RIVERSIDE AVENUE
POST OFFICE BOX 2888
HINSDALE
HOUSTON
CANTON
JACKSONVILLE
TULSA
IL
TX
OH
FL
OK
60521
77099
44735
32202
74101
BENEFIT ADMINISTRATORS
BENEFITS INSURANCE COMPANY
CLAIMS MANAGEMENT
INS. CORP.
INVESTORS LIFE INS. CO.
LAM1R032
RUN: 09/24/16 07:28:56
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DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
70
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
PROFESSIONAL SERVICE INDUSTRIES INC
PROGRESSIVE COUNTY MUTAL INSURANCE
1809-00
1592-00
SPRINGFIELD
HURST
IL
TX
62708
76053
PROGRESSIVE DRIVER SEVICES INC
PROGRESSIVE EMPLOYER'S ASSOC. TRUST
PROMINA NW HEALTH NETWORK
2622-00
1482-00
2846-00
JACKSONVILLE
CLARION
ATLANTA
FL
IA
GA
32245
50525
30339
PRONET
PROSOURCE, INC, LIFEWELL HEALTH PLAN S
3100-00
3065-00
FORT WORTH
KENNESAW
TX
GA
76185
30144
PROTECTED HOME MUTUAL LIFE INS. CO.
PROTECTIVE CASUALTY INS. CO.
PROTECTIVE INSURANCE
PROTECTIVE LIFE INS. CO.
PROTECTIVE SERVICE LIFE INSURANCE
PROVANTAGE
PROVIDENCE LIFE INS CO
PROVIDENCE THRU WHITE CONSOLIDATED INDU WCI POULAN
0389-00
1460-00
4099-00
0390-00
1011-00
2895-00
1794-00
1189-00
SHARON
BATON ROUGE
INDIANAPOLIS
BIRMINGHAM
JACKSON
BROOKFIELD
METAIRIE
SHREVEPORT
PA
LA
IN
AL
MS
WI
LA
LA
16146
70814
46207
35223
39201
53008
70001
71139
PROVIDENT
PROVIDENT
PROVIDENT
PROVIDENT
PROVIDENT
PROVIDENT
PROVIDENT
ALLIANCE LIFE INS. CO.
AMERICAN INSURANCE CO.
INDEMNITY LIFE INS. CO.
INSURANCE
LIFE AND ACCIDENT
LIFE AND ACCIDENT INS CO
LIFE AND ACCIDENT INS. CO.
0391-00
0392-00
0393-00
0754-00
1135-00
0394-01
0394-00
NEWPORT BEACH
DALLAS
BRISTOL
MEMPHIS
GREENSBORO
HOUSTON
CHATTANOOGA
CA
TX
TN
TN
NC
TX
TN
92663
75231
37621
38137
27404
77218
37402
PROVIDENT LIFE AND ACCIDENT INSURANCE CO
PROVIDENT MUTUAL LIFE INS OF TAMPA
PROVIDENT MUTUAL LIFE INS. CO. OF PHILADELPHIA
PROVIDENTIAL LIFE INSURANCE CO
PROVIDERS FIDELITY INS. CO.
PROVINCE HEALTH CARE
PRU-CARE OF NORTH TEXAS
0845-00
0395-01
0395-00
0814-00
1439-00
3071-00
1287-00
BIRMINGHAM
TAMPA
PHILADELPHIA
LITTLE ROCK
BLUE BELLE
HENDERSONVILLE
DALLAS
AL
FL
PA
AR
PA
TN
TX
35216
33630
19101
72203
19422
37077
75206
PRUCARE PLUS
PRUCO LIFE INSURANCE CO OF TEXAS
2104-00
2407-00
JACKSONVILLE
AUSTIN
FL
TX
32231
78711
PRUDENTIAL INS. CO. OF AMERICA
PRUDENTIAL-KROGER BENEFIT PLAN
PTRX
PUBLIC INVESTORS LIFE INS. CO.
PUBLIC AMERICAN LIFE INSURANCE CO
PUBLIC EDUCATION EMPLOYEES HEALTH INSURANCE PLAN
PUBLIC EMPLOYEE HEALTH PLAN
PURINA BENEFITS ASSOCIATION
PURITAN LIFE INS. CO.
PYRAMID LIFE
PYRAMID LIFE INS CO THE
PYRAMID LIFE INS. CO., THE
Q-DENT DENTAL MANAGEMENT CORP
0396-00
0396-01
3887-00
0397-00
1664-00
2194-00
2549-00
2280-00
0398-00
3687-00
3882-00
0399-00
2067-00
P O BOX 3041
301 NORTHEAST LOOP 820
SUITE 205
P O BOX 17775
215 N MAIN ST
1000 CIRCLE 75 PKWY
STE 480
P O BOX 101387
1701 BARRETT LAKE BLVD
SUITE 290
30 EAST STATE STREET
10033 MAMMOTH AVE
P O BOX 7099
2801 HIGHWAY 280 SOUTH
600 EAST AMITE ST
P O BOX 846
808 L & A RD
WEEDEATER SELF INSURED
P O BOX 9328
POST OFFICE BOX 1770
P O BOX 679005
P O BOX 8915
P O BOX 171806
P O BOX 10307
P O BOX 219788
FOUNTAIN SQUARE
PROVIDENT BUILDING
PO BOX 20468
P O BOX 30078
POST OFFICE BOX 7378
P O BOX 8072
POST OFFICE BOX 1120
P O BOX 1439
6060 N CENTRAL EXPRESSWAY
SUITE 750
P O BOX 44097
P O BOX 12487
CAPITOL STATION
P O BOX 4587
P O BOX 44109
4590 LOCKHILL SELMA
POST OFFICE BOX 5484
8585 STEMMONS FREEWAY
2160 HIGHLAND AVE
560 EAST 200 SOUTH
835 S 8TH ST
POST OFFICE BOX 9200
P O BOX 742568
P O BOX 130
POST OFFICE BOX 772
P O BOX 735
HOUSTON
JACKSONVILLE
SAN ANTONIO
ALEXANDRIA
DALLAS
BIRMINGHAM
SALT LAKE CITY
ST.LOUIS
PROVIDENCE
HOUSTON
PENSACOLA
SHAWNEE MISSION
DENHAM SPRINGS
TX
FL
TX
LA
TX
AL
UT
MO
RI
TX
FL
KS
LA
77210
32231
78249
71301
75247
35205
84102
63164
02940
77274
32591
66201
70726
LAM1R032
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DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
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TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
QBE INSURANCE CORPORATION
3430-00
NEW YORK
NY
10005
QUAL MED
2880-00
ALBUQUERQUE
NM
87110
QUALCHOICE
QUALITY BENEFITS
3668-00
3270-00
LITTLE ROCK
ST PETERS
AR
MO
72221
66376
QUALITY PROCESS SERVICE
QUARLES DRILLING CORP. GROUP MEDICAL PLAN
QUIKRETE & AFFILIATED MED BENEFITS TRUST
R H ADMINISTRATORS, INC.
3698-00
2621-00
2054-00
3424-00
LEXINGTON
TULSA
NORFOLK
LUBBOCK
KY
OK
VA
TX
40512
74133
23502
79414
RABENHORST INDUSTRIAL LIFE INS CO
RACELAND SUGAR AGRICULTURE (SELF-INSURED)
RAILROAD RETIREMENT BOARD
RAILROAD RETIREMENT BOARD
RALPH'S OF LAFAYETTE
RAMSAY HEALTH CARE INC BENEFIT PLAN
RAMSEY HEALTH CARE INS.
RANDALL'S HEALTH PLAN
RAPIDES PARISH POLICE JURY
RAPIDES REGIONAL MED CTR GROUP HEALTH PLAN
RAYNE STATE BANK AND TRUST CO.
RBMS
RBMS LLC DBA/RISK&MGMT
RCA PLAN FOR HEALTH
RE MEMBER GROUP HOSPITAL INSURANCE
READING AND BATES INSURANCE CO
REASSURE AMERICA
RED BALL OXYGEN MEDICAL TRUST
1515-00
2277-00
1760-00
H420-50
2024-00
2515-00
2541-00
2180-00
0963-00
2319-00
2763-00
3636-00
3634-00
1433-00
1977-00
1024-00
3105-00
1639-00
BATON ROUGE
RACELAND
AGUSTA
AUGUSTA
LAFAYETTE
NEW ORLEANS
CORAL GABLES
HOUSTON
ALEXANDRIA
ALEXANDRIA
SHREVEPORT
ANCHORAGE
ANCHORAGE
VAN NUYS
LINCOLN
TULSA
DALLAS
SHREVEPORT
LA
LA
GA
GA
LA
LA
FL
TX
LA
LA
LA
AK
AK
CA
NE
OK
TX
LA
70802
70394
30999
30999
70506
70156
33114
77210
71303
71301
71137
99524
99524
91409
68506
74103
75374
71107
REGAL MEDICAL CARE PLAN
REGENCE LIFE & HEALTH INSURANCE COMPANY
REGINA COELI CHILD DEVELOPMENT CENTER
1665-00
2975-00
2418-00
JACKSONVILLE
PORTLAND
COVINGTON
AR
OR
LA
72076
97207
70433
REGIONAL HEALTH PLAN
REGIT
RELIABLE LIFE INS. CO.
RELIANCE STANDARD LIFE CO
RELIANCE STANDARD LIFE INS. CO.
RELIANT STANDARD SPECIALITY
2676-00
2762-00
0400-00
3741-00
0401-00
4095-00
MELVILLE
ST.LOUIS
MONROE
LINCOLN
PHILADELPHIA
MORRESTOWN
NY
MO
LA
NE
PA
NJ
11747
63188
71201
68501
19130
08057
RELIASTAR
RELIGIOUS COMP TRUST
REPUBLIC AMERICAN LIFE INS
2800-00
3010-00
1675-00
MINNEAPOLIS
ROMEOVILLE
DALLAS
MN
IL
TX
55440
60446
75247
REPUBLIC BANKERS LIFE
REPUBLIC NATIONAL LIFE GROUP INS. CO.
REPUBLIC NATIONAL LIFE INS. CO.
REPUBLIC-VANGUARD LIFE INS. CO.
RESERVE INSURED TRUST FOR EMPLOYERS
1978-00
0402-00
0403-00
0404-00
1233-00
88 PINE STREET
16TH FLOOR
6100 UPTOWN BLVD NE
SUITE 400
P O BOX 25601
1421 TRIAD CENTER
STE B
P O BOX 14610
7633 E 63RD/STE 500
P O DRAWER 12569
5502 58TH ST
SUITE 700
833 GOVERNMENT
P O BOX 159
P O BOX 10066
P O BOX 1066
3112 CAMERON ST
P O BOX 56549
P O BOX 145086
P O BOX 4506
BOX 1150
211 FOURTH ST
P O BOX 70100
P O BOX 24159
P O BOX 24159
P O BOX 9126
P O BOX 6963
2200 MID CONTINENT TOWER
P O BOX 749014
SELF-INSURED
P O BOX 7316
1100 REDMOND RD
P O BOX 1071
832 E BOSTON
#10
P O BOX 9062
P O BOX 1085
108 N. 23RD STREET
P O BOX 82510
2501 PARKWAY
505 S LENOTA ROAD
SUITE 231
P O BOX 1195
1205 WINDHAM PARKWAY
8585 STEMMONS FREEWAY
STE 1101
8585 STEMMONS FRWY
POST OFFICE BOX 223647
POST OFFICE BOX 226210
POST OFFICE BOX 223000
ALPHA DATA SYSTEMS,INC
P O BOX 791428
DALLAS
DALLAS
DALLAS
DALLAS
DALLAS
TX
TX
TX
TX
TX
75247
75222
75266
75222
75379
LAM1R032
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TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
RESERVE LIFE INS. CO.
RESERVE NATIONAL INS. CO.
RESOURCE BENEFITS ADMINISTRATORS
RESOURCEONE ADMINISTRATORS
RESTAT GOLDEN FLAKE PHARMACY PLAN
RETAIL CLERK WELFARE TRUST
RETIRED FEDERAL EMPLOYEES HEALTH BENEFITS ACT
RETIRED MACHINISTS HEALTH PLAN
RETIREE MEDICAL INSURANCE
REVCO D S INC
REYNOLDS METALS CO
RICHARDSON MEDICAL CENTER
RILEY-BEAIRD
0405-00
0406-00
3704-00
3410-00
2516-00
2598-00
1002-00
2817-00
3724-00
0981-00
1769-00
2690-00
0919-00
DALLAS
OKLAHOMA CITY
CEDARVILLE
TULSA
WEST BEND
SEATTLE
WASHINGTON
OAKLAND
DES MOINES
TWINSBURG
RICHMOND
RAYVILLE
SHREVEPORT
TX
OK
OH
OK
WI
WA
DC
CA
IA
OH
VA
LA
LA
75222
73118
45314
74159
53095
98111
20044
94623
50306
44087
23261
71269
71130
RISK FUNDING
RISK MANAGEMENT INC
RISK MANAGEMENT INC
RITE AID HEALTH SOLUTIONS
RIVERLAND MEDICAL CENTER EMERGENCY MEDICAL SERVICE
RIVERSIDE LIFE INS. CO.
RLC-CORPORATION-EMPLOYEE BENEFIT TRUST
RMSCO INC
ROADWAY SERVICES INC
2250-00
1080-00
2544-00
3789-00
2737-00
0407-00
1464-00
2202-00
2295-00
TYLER
BATON ROUGE
BATON ROUGE
CAMP HILL
FERRIDAY
NEW ORLEANS
WILMINGTON
SYRACUSE
AKRON
TX
LA
LA
PA
LA
LA
DE
NY
OH
75713
70898
70898
17011
71334
70152
19899
13203
44309
ROBERT C. BOWCK INC
ROBERT S WEISS CO
ROBEY BARBER INSURANCE CORPORATION
ROBINSON & JULIENNE BAILEY COMPANY
ROBINSON-CONNER INSURANCE
ROCKWOOD INSURANCE CO
ROLLINS ENVIRONMENTAL SERVICES EMPLOYEE BENEFIT TRUST
ROLLINS INC
ROSEWOOD NURSING CENTER INC (SELF-INSURED)
ROWAN COMPANIES INC
2106-00
1620-00
1361-00
1476-00
1783-00
1976-00
1672-00
1386-00
1957-00
1776-00
LEAWOOD
STAMFORD
TAMPA
JACKSON
ERIE
NOBLESVILLE
WILMINGTON
ATLANTA
LAKE CHARLES
HOUSTON
KS
CT
FL
MS
PA
IN
DE
GA
LA
TX
66200
06901
33629
39206
16501
46060
19899
30301
70601
77056
ROYAL NEIGHBORS OF AMERICA
RR MAINT & INDU HLTH & WELFARE FUND
RSI CONSTRUCTION
RSL SPECIALTY PRODUCTS
3468-00
3607-00
2143-00
3828-00
CLEARWATER
SPRINGFIELD
SHREVEPORT
MOORESTOWN
FL
IL
LA
NJ
33757
62704
71135
05087
RUBY TUESDAY, INC. (SELF-INSURED
RURAL CARRIER BENEFIT PLAN
RURAL CARRIER BENEFIT PLAN
3123-00
4041-00
0945-00
MARYVILLE
LONDON
ROCKVILLE
TN
KY
MD
37801
40472
20850
RURAL ELECTRIC MEMBER GROUP HOSPITAL PLAN
RUSKIN INDUSTRIES
RX AMERICA
RX AMERICA
RX BENEFITS
RX OPTIONS
RX PRIME PHARMACEUTICAL SERVICES
1608-00
2614-00
3419-00
3402-00
4115-00
3397-00
2837-00
403 SOUTH AKARD STREET
6100 NORTH GRAND BLVD
P O BOX 27
P O BOX 4830
P O BOX 758
P O BOX 2265
P O BOX 14172
P O BOX 24263
P O BOX 10432
1925 ENTERPRISE PARKWAY
P O BOX C-32029
P O BOX 388
P O BOX 31115
601 BENTON KELLY
P O BOX 130217
P O BOX 14177
P O BOX 14177
30 HUNTER LN
P O BOX 111
POST OFFICE BOX 52949
P O BOX 1791
731 JAMES ST
RISK MANAGEMENT DEPT
P O BOX 88
P O BOX 6353
WHITEAKER PLACE/MILL ROAD
3965 HENDERSON BLVD
P O BOX 9407
1030 STATE ST
P O BOX 358
P O BOX 1791
P O BOX 647
534 FIFTEENTH STREET
5051 WESTHEIMER
SUITE 1900
P O BOX 10850
2725 WEST MONROE STREET
P O BOX 52868
505 S LENOLA ROAD
SUITE 231
150 CHURCH AVE
P O BOX 7404
51 MONROE ST
PLAZA LEVEL
16565 SOUTH STATE ST
THOMPKIN IRVING DR
P O BOX 4165
P O BOX 4165
P O BOX 382377
2181 E AURORA RD
P O BOX
SOUTH HOLLAND
MINDEN
WOODLAND HILLS
WOODLAND HILLS
BIRMINGHAM
TWINSBURG
HARTFORD
IL
LA
CA
CA
AL
OH
CT
60473
71201
91365
91365
35243
44087
06142
LAM1R032
RUN: 09/24/16 07:28:56
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DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
73
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
RY-RON INC
RYDER SYSTEMS INC
2098-00
1310-00
HOUSTON
MIAMI
TX
FL
77210
33102
S I B S
S J A BROOKAGE
S.C.H. CLAIMS ADMINISTRATION
1714-00
2717-00
1551-00
PARK RIDGE
DALLAS
HOUSTON
IL
TX
TX
60068
75380
77292
S.R.C. INSURANCE CO
SADDLE CREEK CORPORATION
SAFECO LIFE INS. CO.
SAFETY NET INSURANCE CO
SAFEWAY GROUP BENEFITS
SAIPLUS
2243-00
2922-00
0409-00
3433-00
2512-00
3017-00
COLUMBIA
LAKELAND
SEATTLE
ST LOUIS PARK
OAKLAND
ROCKVILLE
SC
FL
WA
MN
CA
MD
29224
33801
98105
50416
94604
20850
SAMARITAN MINISTRIES
SAMBA (CIGNA)
SAMMONS MEDICAL EXPENSE
4040-00
3753-00
3379-00
PEORIA
SCRANTON
DALLAS
IL
PA
TX
61612
18505
75207
SAN DIEGO ELECTRICAL TRUST
SAN FRANCISCO ADMINISTRATORS
SAN FRANCISCO PRINTING INDUSTRY WELFARE FUND
SANDERS EMPLOYEE BENEFIT PLAN
SANDERSON FARMS INC
SANTA FE EMPLOYEES HOSPITAL ASSOC
SANTA FE INTERNATIONAL CORPORATION
SANUSPLUS
3196-00
2674-00
1436-00
2454-00
2495-00
3233-00
1179-00
1951-00
SAN DIEGO
SAN FRANCISCO
SAN FRANCISCO
TROY
LAUREL
COVINA
LAFAYETTE
HOUSTON
CA
CA
CA
AL
MS
CA
LA
TX
92194
94107
94120
36081
39441
91723
70505
77098
SAVANNAH FOODS & INDUSTRIES INC
SAVE RX
SAVERS LIFE INS. CO.
SAVINGS LIFE INS. CO.
SAVOY MEDICAL CENTER(SELF-INSURED)
SAWYER DRILLING & SERVICE INC.(SELF-INSURED)
SC UNITED FOOD COMM WKRS UNIONS EMP HLT WEL TRUST
SCHAD INDUSTRIES BENEFIT TRUST
SCHALLER ANDERSON HEALTHCARE
SCHLUMBERGER GROUP HEALTH CARE TRUST
SCHOEN LIFE INS CO INC
SCHULLER INTERNATIONAL,INC
SCHUMPERT MEDICAL CENTER-BENEFLEX-SCH CLAIMS
2273-00
3246-00
2738-00
0411-00
1255-00
2020-00
1143-00
2476-00
3164-00
0896-00
0789-00
2920-00
1722-00
SAVANNAH
FREEMONT
WINSTON-SALEM
SHREVEPORT
MAMOU
SHREVEPORT
MESQUITE
OPELOUSAS
BOSSIER CITY
SHERMAN
NEW ORLEANS
RICHARDSON
SHREVEPORT
GA
NE
NC
LA
LA
LA
TX
LA
LA
TX
LA
TX
LA
31402
68026
27116
71130
70554
71101
75150
70571
71171
75090
70179
75083
71120
SCOTSMAN INSURANCE CO-EMPLOYEE GROUP COVERAGE
SCOTT AND WHITE HEALTH PLAN
SCREEN ACTORS GUILD
0933-00
1141-00
1839-00
SANTA ROSE
TEMPLE
BURBANK
CA
TX
CA
95406
76508
91510
SCRIP WORLD, LLC
4117-00
SALT LAKE CITY
UT
84123
SCRIPT CARE INC
SCRIPT CARE, LTD.
SEABOARD INSURANCE
SEABURY AND SMITH
2215-00
3420-00
2874-00
1979-00
P O BOX 4582
EMPLOYEE BENEFITS
P O BOX 020816
222 S PROSPECT
P O B 809059
2600 N LOOP WEST STE 520
P O BOX 922013
P O BOX 23759
3010 SADDLE CREEK ROAD
4347 BROOKLYN AVE N.E.
1601 UTICA AVE SOUTH
P O BOX 2099
1803 RESEARCH BLVD
STE 402
P O BOX 3618
P O BOX 6010
2777 N STEMMONS FAIRWAY
STE 1525
P O BOX 231219
501 SECOND ST #212
P O BOX 7051
P O DRAWER 707
P O BOX 988
551 EAST SAN BERNADINO RD
P O BOX 5272
3800 BUFFALO SPDWY
P O BOX 56228
P O BOX 339
P O BOX 8
P O BOX 11947
POST OFFICE BOX 33999
801 POINCIANA AVE
220 TRAVIS/STE 500
3218 E HWY 67 SUITE 120
P O BOX 591
P O BOX 71200
P O BOX 2546
P O BOX 19263
PO BOX 833823
HEALTH ADVANTAGE
P O BOX 22255
P O BOX 6675
2401 SOUTH 31ST ST
3601 WEST OLIVE AVE
P O BOX 7830
4246 RIVERBOAT ROAD
SUITE 175
87 IH NORTH, SUITE 100
6380 FOLSOM DR
525 S MERIDIAN
1750 WILLIAMS CT TOWER 2
TWO WEST 2ND ST
BEAUMONT
BEAUMONT
INDIANAPOLIS
TULSA
TX
TX
IN
OK
77707
77706
46206
74103
LAM1R032
RUN: 09/24/16 07:28:56
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DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
74
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
SEAFARERS HEALTH AND BENEFITS PLAN
SEAFARERS WELFARE PLAN
3602-00
0929-00
PINEY POINT
CAMP SPRINGS
MD
MD
20674
20746
SEAGATE BENEFIT ASSOCIATION
SEARS HEALTH & GROUP BENEFITS
SEARS RETIREE GROUP MEDICAL PLAN
SECURE CARE 65
SECURE HORIZONS MEDICARE DIRECT
SECURE HORIZONS OF TEXAS
SECURITY ASSURANCE CO.
SECURITY BENEFIT LIFE INS. CO.
SECURITY FIRST TRUST
0866-00
3539-00
2470-00
1015-00
3619-00
3927-00
0412-00
0413-00
1902-00
JACKSONVILLE
THE WOODLANDS
PHILADELPHIA
VALLEY FORGE
SALT LAKE CITY
PENSACOLA
OMAHA
TOPEKA
MONROE
FL
TX
PA
PA
UT
FL
NE
KS
LA
32245
77381
19101
19482
84131
32591
68102
66603
71211
SECURITY GENERAL LIFE INS. CO.
SECURITY INDUSTRIAL INS. CO.
SECURITY LIFE INS. CO. OF AMERICA
SECURITY LIFE OF DENVER INS. CO.
SECURITY SOUTHWEST LIFE INS. CO.
SECURITY TRUST LIFE
SECURITY-CONNECTICUT LIFE INS. CO.
SEDGWICK JAMES INC
SEDGWICK NOBLE NOWLDS
SEIBERT-KECK AGENCY
SELECT BENEFIT ADMIN. OF AMERICA
SELECT CARE OF TEXAS
SELECT EMPLOYERS INSURANCE TRUST
SELECT HORIZONS
SELF FUNDING ADMINISTRATORS
SELF FUNDING ADMINSTRATORS
SELF INSURANCE ADMINISTRATORS INC
SELF INSURANCE INC
SELF INSURED SERVICES CO (SISCO)
SELF-FUNDED PLANS,INC (PEPSI-COLA,7-UP
0415-00
0416-00
0418-00
0417-00
0419-00
1003-00
0414-00
2602-00
2735-00
1606-00
3411-00
H450-60
1213-00
3500-00
3942-00
2364-00
1622-00
0732-00
1998-00
0937-00
OKLAHOMA CITY
DONALDSONVILLE
RICHARDSON
DENVER
EL PASO
MACON
AVON
JACKSON
WARMINISTER
AKRON
ASHLAND
HOUSTON
NEW ORLEANS
SALT LAKE CITY
ANNAPOLIS
CLEARWATER
LAFAYETTE
ST MARTINVILLE
DUBUQUE
CLEVELAND
OK
LA
TX
CO
TX
GA
CT
MS
PA
OH
WI
TX
LA
UT
MD
FL
LA
LA
IA
OH
73154
70346
75083
80202
79950
31297
06001
39225
18974
44313
54806
77081
70181
84131
21401
34620
70598
70582
52004
44114
SEMOLINA INC DAY ONE MEDICAL PLAN
SENIOR AMERICAN GROUP INSURANCE TRUST
SENIOR CARE
SENIOR SECURITY PRESCRIPTION PLAN
SENTARA HEALTH PLANS INC
SENTARA HEALTHCARE
SENTINEL INSURANCE GROUP
SENTINEL SECURITY LIFE INS CO
SENTRY LIFE INS. CO.
3158-00
2121-00
3190-00
3252-00
3362-00
3892-00
2080-00
3835-00
0420-00
FORT WORTH
PHILADELPHIA
TALLULAH
VALLEY FORGE
VIRGINIA BEACH
NORFOLK
BETHLEHEM
CLEARWATER
STEVENS POINT
TX
PA
LA
PA
VA
VA
PA
FL
WI
76147
19102
71284
19482
23462
23502
18017
33766
54481
SEPCO INDUSTRIES INC
SERVICE EMPLOYEES INTERNATIONAL UNION
2321-00
1767-00
HOUSTON
WASHINGTON
TX
DC
77002
20090
SERVICES DISTRIBUTED
SETON HEALTH PLAN
SEVEN CORNERS
SHARED MEDICAL ALTERNTAIVES
2023-00
3333-00
3483-00
3068-00
P O BOX 380
SEAFARERS INTERNATL UNION
5201 AUTHWAY
PO BOX 17805
2601 RESEARCH BLVD
P O BOX 41573
P O BOX 1717
P O BOX 31353
P O BOX 12466
105 SOUTH 17TH STREET
700 HARRISON
INS.RESOURCES MANAGEMENT
P O BOX 4705
POST OFFICE BOX 18810
110 RAILROAD AVENUE
P O BOX 836150
SECURITY LIFE BUILDING
POST OFFICE BOX 1889
P O BOX 4287
SECURITY DRIVE
P O BOX 24117
P O BOX C 5009-0580
2950 W MARKET ST
P O BOX 440
4888 LOOP CENTRAL DR
P O BOX 10533
P O BOX 31353
P O BOX 6596
14440 MYERLAKE CIRCLE
P O BOX 81189
305 WASHINGTON ST
P O BOX 389
OF LAKE CHARLES)
1432 HAMILTON AVE
P O BOX 9137
2 PENN CENTER PLAZA
900 JOHNSON ST
P O BOX 1340
4417 CORPORATION LN
6015 POPLAR HALL DR
3900 BURGESS RD
P O BOX 16960
BOX 1700
ATTEN GROUP HEALTH CLAIMS
440 LOUISIANA ST
HEALTH & WELFARE FUND
P O BOX 90980
P O BOX 3090
P O BOX 15507
P O BOX 3430
P O BOX 51098
LAFAYETTE
AUSTIN
CARMEL
RIVERSIDE
LA
TX
IN
CA
70502
78761
46082
92517
LAM1R032
RUN: 09/24/16 07:28:56
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DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
75
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
SHASTA ADIMINISTRATIVE SERVICES
SHAW INDUSTRIES
SHEARMAN CORPORATION DBA
SHEER METAL WORKERS LOCAL NO 361 WELFARE FUND
SHEET METAL WORKER NATIONAL HEALTH FUND
SHEET METAL WORKER'S INT.,LOCAL 265
SHEET METAL WORKERS WELFARE PLAN
3821-00
2334-00
2385-00
1016-00
1703-00
1707-00
0953-00
REDMOND
THOMSON
LAKE CHARLES
SHREVEPORT
ALEXANDRIA
CAROL STREAM
LOS ANGELES
OR
GA
LA
LA
VA
IL
CA
97756
30824
70602
71103
22314
60188
90076
SHELTER LIFE INS. CO.
SHENANDOAH LIFE
0421-00
1419-00
COLUMBIA
BATON ROUGE
MO
LA
65201
70898
SHERIFF'S GROUP BENEFITS PROGRAM
SHERMAN CORP
SHETFIELD OLSON & MCQUEEN
SHIELD OF SHELTER
SHONEY'S (SELF-INSURED)
SHREVEPORT ELECTRICAL HEALTH & WELFARE FUND
SIBLING FINANCIAL CORP
2365-00
2217-00
3364-00
1172-00
1913-00
1111-02
2064-00
NEW IBERIA
LAKE CHARLES
ST PAUL
BATON ROUGE
NASHVILLE
SHREVEPORT
SHREVEPORT
LA
LA
MN
LA
TN
LA
LA
70560
70602
55116
70806
37229
71129
71105
SIERRA HEALTH & LIFE INSURANCE
SIERRA HEALTH AND LIFE
SIERRA VILLAGE HEALTH
SIGNAL MUTUAL INS CO
SIGNATURE DENTAL PLAN
SILVERSCRIPT
SILVERSTONE GROUP
3678-00
2755-00
H290-50
1223-00
2654-00
3360-00
3067-00
LAS VEGAS
JACKSON
LAS VEGAS
BEAUMONT
SCHAUMBURG
PHOENIX
OMAHA
NV
MS
NV
TX
IL
AZ
NE
89114
39208
89114
77704
60173
85072
68154
SIMMONS GROUP MEDICAL
SIMPLE INSURANCE
3669-00
1523-00
ROGERS
LOS ANGELES
AR
CA
72757
90067
SIMPLEX TIME RECORDER SELF INSURED AS COMPLETE
1194-00
GARDNER
MA
01441
SIMPLY HEALTH CARE
SINCLAIR
SISCO
SISTERS OF CHARITY OF THE INCARNATE WORK HLT PLAN
SISTERS OF THE HOLY FAMILY
SKILSTAF
SKYLINE CORPORATION
3988-00
3928-00
3438-00
1025-00
2873-00
3157-00
2305-00
EAGAN
SALT LAKE CITY
DUBUQUE
COLORADO SPRINGS
NEW ORLEANS
ALEXANDER CITY
ELKHART
MN
UT
IA
CO
LA
AL
IN
55121
84130
52004
80901
70126
35011
46515
SLIDELL MEMORIAL HOSPITAL EMPLOYEE HEALTH PLAN
SMA LIFE ASSURANCE CO.
SMALL BUSINESS MAN'S INSURANCE ASSOCIATION
SMC INC
SMITH ADMINISTRATORS
SNL ADMINISTRATORS
SOCIETY NATIONAL GROUP - HEALTH TECH DYNAMICS
SOI HEALTH PLANS
SONAT,INC
SONITROL MANAGEMENT CORP
SONOCO PRODUCTS COMPANY
2919-00
0408-00
2906-00
2991-00
3370-00
2684-00
1000-00
3372-00
0995-00
2061-00
2768-00
P O BOX 1747
P O BOX 960
P O BOX 2893
2515 FULTON
601 N FAIRFAX ST
106 N SCHMALE RD
SOUTH CALIFORNIA
PO BOX 76886
1817 WEST BROADWAY
ALPHA CORPORATION
P O BOX 14786
300 IBERIA ST/STE 120
P O BOX 2893
2145 FORD PKWY #300
1956 BEAUMONT DR
P O BOX 290489
5510 BUNCOMBE RD
310 KNIGHT ST
SUITE 300
P O BOX 15645
2506 LAKELAND DR #402
P O BOX 15645
P O BOX 3463
200 N MARTINGALE RD
P O BOX 52066
11516 MIRACLE HILLS DR
SUITE 102
P O BOX 1627
COMMERCIAL SALES & SERV
1801 AVE OF THE STARS
CARE CONTROL
SIMPLEX PLAZA
P O BOX 21535
P O BOX 30827
P O BOX 389
P O BOX 529
6901 CHEF MENTEUR HWY
P O BOX 729
2520 BYPASS RD
P O BOX 743
1051 GAUSE BLVD 225
440 LINCOLN STREET
8281 LAFAYETTE ST
P O DRAWER 1979
P O BOX 853937
P O BOX C5009
9101 WESTLEYAN RD
P O BOX 241508
PO BOX 2563
P O BOX 55210
7025 ALBERT PICK RD
5TH FLOOR
SLIDELL
WORCESTER
DENHAM SPRINGS
SEARCY
RICHARDSON
WARMINSTER
INDIANAPOLIS
CHARLOTTE
BIRMINGHAM
INDIANAPOLIS
GREENSBORO
LA
MA
LA
AR
TX
PA
IN
NC
AL
IN
NC
70458
01605
70726
72145
75085
18974
45268
28224
35202
46205
27409
LAM1R032
RUN: 09/24/16 07:28:56
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DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
76
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
SOONER INSURANCE
2790-00
OKLAHOMA CITY
OK
73112
SOUTH
SOUTH
SOUTH
SOUTH
2147-00
3751-00
1208-00
3720-00
3555 NW 58TH ST
#400
8720 RED OAK BLVD/STE 227
P O BOX 90802
1451 EAST OCEAN BLVD
12160 N ABRAMS RD
SUITE 201
9550 SKILLMAN
SUITE 410
3218 EAST HWY 67
SUITE 120
P O BOX 159
P O BOX 4037
215 SOUTH SECOND ST
HERITAGE PLZA SUITE 230
111 VETERANS MEM. BLVD
4041 MARKET ST
STE 538
P O BOX 51005
P O BOX 12830
POST OFFICE BOX 33999
PERSONNEL DEPT.
2700 NAPOLEON AVE.
P O BOX 1449
222 W LAS COLINAS BLV 756
2400 VETERANS BLVD
SUITE 140
P O BOX 400
P O BOX 10265
515 SO. AVE 19
501 SHATTO PLACE 5TH FL.
2088 IDLEWOOD
SUITE 5
POST OFFICE BOX 1984
3928 VOLUNTEER DR
P O BOX 1800
POST OFFICE BOX 78
P O BOX 5489
P O BOX 9120
PO DRAWER 3248
P O BOX 431890
4534 WRNALL RD
600 JEFFERSON AVE
P O BOX 97
6001 FINANCIAL PLAZA
P O BOX 30753
P O BOX 2469
P O BOX 870
485 MADISON AVENUE
POST OFFICE BOX 21887
P O BOX 15449
CHARLOTTE
LUBBOCK
VERO BEACH
DALLAS
NC
TX
FL
TX
28217
79408
33494
75243
DALLAS
TX
75243
MESQUITE
TX
75150
RACELAND
HOUMA
EUNICE
METAIRIE
LA
LA
LA
LA
70394
70360
70535
70005
SHREVEPORT
LA
71101
SHREVEPORT
JACKSON
SHREVEPORT
NEW ORLEANS
LA
MS
LA
LA
71135
35211
71130
70115
GODLETTSVILLE
IRVING
KENNER
TN
TX
LA
37070
75039
70062
BUCKEYSTOWN
BIRMINGHAM
LOS ANGELES
LOS ANGELES
TUCKER
MD
AL
CA
CA
GA
21717
35202
90031
90020
30084
NASHVILLE
CHATTANOOGA
RIDGELAND
JACKSON
LITTLE ROCK
DES MOINES
ENID
SOUTH MIAMI
KANSAS CITY
MEMPHIS
TN
TN
MS
MS
AK
IA
OK
FL
MO
TN
37202
37416
39158
39205
72119
50306
73702
33243
64111
38101
SHREVEPORT
TAMPA
TUSCALOOSA
WEST POINT
NEW YORK
GREENSBORO
BATON ROUGE
LA
FL
AL
MS
NY
NC
LA
71130
33630
35403
39773
10022
27402
70895
CAROLINA LOCAL GOVERNMENT ASSURANCE GRP
CENTRAL (UFCW-PPO PLUS)
CENTRAL EDUCATION RISK MANAGEMENT PROG
CENTRAL HEALTH
SOUTH CENTRAL HEALTH & WELFARE TRUST
2195-00
SOUTH CENTRAL UNITED FOOD COMMERCIAL WORKERS UNION
1469-00
SOUTH
SOUTH
SOUTH
SOUTH
2140-00
2274-00
0716-00
2645-00
COAST SUGARS (SELF-INSURED)
LA. ELECTRIC COOK ASSN
LOUISIANA INSURANCE AGENCY
WEST MEDICAL ALLIANCE
SOUTHEAST FINANCIAL CORP
1673-00
SOUTHEAST FOODS INC
SOUTHERN ADMIN & BENEFIT CONSULTANTS
SOUTHERN BANKERS LIFE INS. CO.
SOUTHERN BAPTIST HOSPITAL
1812-00
0820-00
0422-00
0513-00
SOUTHERN BENEFIT ADMINISTRATORS IN
SOUTHERN BENEFIT CONSULTANTS INC
SOUTHERN BENEFIT SERVICES
3557-00
2118-00
3682-00
SOUTHERN
SOUTHERN
SOUTHERN
SOUTHERN
SOUTHERN
BENEFIT SERVICES
BENEFITS SERVICES,INC
CALIFORNIA IBEW NECA HEALTH FUND
CALIFORNIA PIPE TRADE TRUST FUND
CARE ENTERPRISES
3749-00
1062-00
1039-00
1917-00
1736-00
SOUTHERN
SOUTHERN
SOUTHERN
SOUTHERN
SOUTHERN
SOUTHERN
SOUTHERN
SOUTHERN
SOUTHERN
SOUTHERN
COUNCIL OF INDUSTRIAL WORKERS
ELECTRIC HEALTH FUND
FARM BUREAU CASUALTY INS. CO.
FARM BUREAU LIFE INS. CO.
FARMERS ASSOCIATION INC
FARMERS ASSOCIATION,INC
FIDELITY LIFE INSURANCE CO.
GENERAL LIFE INS CO
GULF OIL DISTRICT
HEALTH PLAN
0507-00
3231-00
2336-00
0423-00
1243-01
1243-00
0997-00
1182-00
1455-00
2036-00
SOUTHERN
SOUTHERN
SOUTHERN
SOUTHERN
SOUTHERN
SOUTHERN
SOUTHERN
HERITAGE LIFE INS. CO.
HOLDINGS
INSURANCE MANAGEMENT ASSOCIATION
IONICS INC
LIFE AND HEALTH INS. CO.
LIFE INS. CO.
MARKETING SERVICE/LA
0424-00
2565-00
2199-00
3109-00
0425-00
0426-00
1065-00
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
77
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
SOUTHERN
SOUTHERN
SOUTHERN
SOUTHERN
SOUTHERN
MEDICAL ALLIANCE HEALTH PLAN
MEDICAL ASSOCIATION
MEDICAL LIFE INS COMP
NATIONAL INSURANCE CO.
PAINTERS WELFARE FUND
2813-00
1294-00
1589-00
2943-00
2132-00
HARAHAN
BIRMINGHAM
WACO
BATON ROUGE
ATLANTA
LA
LA
TX
LA
GA
70123
35209
76703
70898
30345
SOUTHERN
SOUTHERN
SOUTHERN
SOUTHERN
PLASTICS INC
RISK CONSULTANTS
SCRIPTS
SECURITY LIFE INS. CO.
1506-00
1865-00
3943-00
0427-00
6437 JEFFERSON HWY
85 BAGBY DR SUITE 216
P O BOX 1548
P O BOX 98044
2300 HENDERSON MILL RD
N.E. SUITE 414
P O BOX 9159
P O BOX 20046
407 BIENVILLE ST
151 WYMORE ROAD
STE. 450
SELF INSURED
P O BOX 1268
P O BOX 37503
HEALTH AND WELFARE TRUST
16225 PARK TEN PLACE #460
7320 GREENWOOD RD
116 CATOMA STREET
P O BOX 711
P O BOX 33888
315 MONROE ST
SUITE B
P O BOX 29098
8140 MOPAC EXPRESWAY WEST
PARK 4 SUITE 205
1715 COMMON ST
4020 MC EWEN DR.
SUITE 280
P O BOX 542814
PH# 214-358-7551
(SELF-INSURED PROGRAM)
P O BOX 28510
P O BOX 18600
P O BOX 141239
1400 C BARKSDALE BLVD
P O BOX 21106
POST OFFICE BOX 2699
4600 GOLDFIELD
887 MITTEN RD
STE 200
11301 OLD GEORGETOWN RD
11301 OLD GEORGETOWN RD
P O BOX 250349
P O BOX 4130
1320 LAKEWOOD DR
P O BOX 606
P O BOX 6860
2811 LORD BALTIMORE DR
200 PEACH ST
1250 STATE STREET
P O BOX 1389
SHREVEPORT
ST.PETERSBURG
NATCHITOCHES
ALTAMONTE SPRINGS
LA
FL
LA
FL
71139
33742
71457
32701
OPELOUSAS
LA
70570
OAK PARK
HOUSTON
MI
TX
48237
77084
SHREVEPORT
MONTGOMERY
DALLAS
SHREVEPORT
BOSSIER CITY
LA
AL
TX
LA
LA
71119
36104
75221
71130
71111
SAN ANTONIO
AUSTIN
TX
TX
78229
78759
LAKE CHARLES
DALLAS
LA
TX
70601
75244
DALLAS
TX
75354
SAN ANTONIO
TX
78284
FORT WORTH
IRVING
BOSSIER CITY
SHREVEPORT
DALLAS
SAN ANTONIO
BURLINGAME
TX
TX
LA
LA
TX
TX
CA
76118
75014
71111
71156
75221
78218
94010
NORTH BETHESDA
NORTH BETHESDA
PLANO
SLIDELL
MD
MD
TX
LA
20852
20852
75025
70459
SCOTT
SHREVEPORT
BALTIMORE
ELDORADO
SPRINGFIELD
MENTOR
LA
LA
MD
AR
MA
OH
70583
71136
21244
71730
01133
44061
SOUTHERN STANDARD FITTINGS
1408-00
SOUTHERN STATES HEALTH & WELFARE FUND
SOUTHERN TEXAS LABORER'S DISTRICT COUNCIL
1178-00
2590-00
SOUTHERN TIRE MART
SOUTHERN UNITED LIFE INS. CO.
SOUTHLAND EMPLOYEES WELF TRUST
SOUTHMARK HERITAGE
SOUTHWEST ADMINISTRATORS
3268-00
0428-00
0429-00
1388-00
1111-00
SOUTHWEST HEALTH CLAIMS SERVICE
SOUTHWEST HOME LIFE
1733-00
1309-00
SOUTHWEST LOUISIANA ELECTRICAL WELFARE FUND
SOUTHWEST PREFERRED HEALTH NETWORK,INC
1073-00
1077-00
SOUTHWEST REGIONAL COUNCIL
1322-00
SOUTHWEST RESEARCH INSURANCE COMPANY
1010-00
SOUTHWEST SERVICE LIFE INSURANCE COMPANY
SOUTHWEST, AN AETNA HEALTH PLAN
SOUTHWESTERN ADMINISTRATORS
SOUTHWESTERN ELECTRIC POWER (SELF-INSURED)
SOUTHWESTERN LIFE INS. CO.
SOUTHWESTERN MOTOR TRANSPORT
SOUTHWESTERN SECURITY SERVICES INC
1121-00
2432-00
2743-00
2032-00
0430-00
2434-00
3442-00
SPECIAL AGENT MUTUAL BENEFIT ASSOC (SAMBA)
SPECIAL AGENT MUTUAL BENEFIT ASSOCIATION
SPECIAL INSURANCE SERVICES
SPECIALTY FOOD SYSTEMS
2128-40
2184-00
3547-00
3135-00
SPECIALTY MACHINE & SUPPLY INC
SPECIALTY OIL COMPANY
SPECTERA UNITED OPTICAL
SPRADLEY & COKER INSURANCE CO.
SPRINGFIELD LIFE INS. CO., INC.
SRX PHARMACY SPECIALIST
2625-00
1999-00
3002-00
1092-00
0431-00
2869-00
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
78
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
ST FRANCIS CABRINI HOSP CLAIMS ADMINISTRATION
1644-00
HOUSTON
TX
77292
ST
ST
ST
ST
ST
FRANCIS HOSPITAL INSURANCE SYSTEM,INC
JAMES PARISH COUNCIL
JOHNS CLAIMS ADMINISTRATION
JOHNS CLAIMS ADMINISTRATIONS
MARTIN PARISH SCHOOL BOARD/SELF
1330-00
1393-00
3781-00
3208-00
0890-00
JACKSON
CONVENT
SPRINGFIELD
SPRINGFIELD
NEW IBERIA
MS
LA
MO
MO
LA
39211
70723
65814
65814
70560
ST. CHARLES PARISH SCHOOL BOARD
ST. PAUL LIFE INS. CO.
ST.LANDRY PARISH SCHOOL BOARD(SELF-INSURED)
STAFFING CONCEPTS
2536-00
0410-00
1924-00
2730-00
LULING
ST. PAUL
OPELOUSAS
TAMPA
LA
MN
LA
FL
70070
55102
70571
33607
STANDARD LIFE AND ACCIDENT INS CO
STANDARD LIFE AND ACCIDENT INS. CO.
STANDARD LIFE AND CASUALTY INS. CO.
STANDARD LIFE INS. CO.
STANDARD OF AMERICA LIFE INS. CO., THE
STANDARD REGISTER GROUP HEALTH CLAIMS
STANDARD SECURITY LIFE INS. CO. OF NY
STAR BENEFITS
STAR MARKETING ADMINISTRATION INS. CO.
STARBRIDGE
STARMARK CLAIMS
STARMOUNT DENTAL
STATE BANK & TRUST CO.
STATE BAR OF TEXAS INSURANCE TRUST
STATE FARM
STATE FARM HEALTH INSURANCE
STATE GROUP BENEFITS
STATE HEALTH BENEFIT PLAN
STATE LIFE INS. CO., THE
STATE MUTUAL COM
STATE MUTUAL INSURANCE COMPANY
3871-00
0433-00
0434-00
0435-00
0432-00
2531-00
0436-00
2030-00
1521-00
2698-00
3674-00
3112-00
2520-00
2740-00
0702-00
3632-00
3905-00
1291-00
0437-00
1610-00
3061-00
SAN ANTONIO
OKLAHOMA CITY
ROCK HILL
JACKSON
PARK RIDGE
DAYTON
NEW YORK
PHOENIX
DES PLAINES
PHOENIX
CLINTON
BATON ROUGE
SHREVEPORT
AUSTIN
NEWARK
GREELEY
BATON ROUGE
ATLANTA
INDIANAPOLIS
WORCESTER
CLEARWATER
TX
OK
SC
MS
IL
OH
NY
AZ
IL
AZ
IA
LA
LA
TX
OH
CO
LA
GA
IN
MA
FL
78269
73193
29730
39205
60068
45401
10022
85051
60018
85078
52733
70898
71137
78711
43058
80633
70896
30334
46206
01605
33755
STATE
STATE
STATE
STATE
STATE
0438-00
0439-00
2423-00
1543-00
2805-00
2600 N LOOP WEST/STE 520
P O BOX 922013
P O BOX 12830
COURTHOUSE BLDG
P O BOX 14230
P O BOX 14409
INSURED ADMINISTRATORS
P O BOX 9670
P O BOX 46
385 WASHINGTON STREET
P O BOX 310
4350 W CYPRESS ST
SUITE 900
P O BOX 696800
421 NORTHWEST 13TH STREET
POST OFFICE BOX 11677
POST OFFICE BOX 1729
EXECUTIVE PLAZA
P O BOX 1167
485 MADISON AVENUE
7122 N 27TH AVE/STE 200
1400 EAST TOUHY ST.
P O BOX 55270
P O BOX 2942
P O BOX 14389
P O BOX 70100
P O BOX 12487
P O BOX 3070
P O BOX 339403
P O BOX 6639
P O BOX 347039
POST OFFICE BOX 406
440 LINCOLN ST-N082
33 NORTH GARDEN AVE
STE 1100
440 LINCOLN STREET
POST OFFICE DRAWER 3557
50 NORTH RIPLEY
P O BOX 2896
PUBLIC SCHOOL EMPLOYEES
P O BOX 5420
P O BOX 30025
POST OFFICE BOX 1509
POST OFFICE BOX 140500
POST OFFICE BOX 66607
P O BOX 5348
P O BOX 10848
P O BOX 5348
P O BOX 5348
P O BOX 269003
P O BOX 69314
WORCESTER
BATON ROUGE
MONTGOMERY
JACKSONVILLE
JACKSON
MA
LA
AL
FL
MS
01605
70821
36130
32232
39288
DURHAM
FORT WORTH
DALLAS
HOUSTON
BELLINGHAM
CLEARWATER
BELLINGHAM
BELLINGHAM
PLANO
HARRISBURG
NC
TX
TX
TX
WA
FL
WA
WA
TX
PA
27702
76101
75214
77006
98227
33757
98227
98227
75026
17106
MUTUAL LIFE ASSURANCE CO. OF AMERICA
NATIONAL LIFE INS. CO.
OF ALABAMA
OF FLORIDA EMPLOYEE GRP HLTH SELF-INS
OF MISSISSIPPI
STATE OF N CAROLINA COMPREHENSIVE MED PLAN
STATE RESERVE LIFE INS. CO.
STATES GENERAL LIFE INS. CO.
STATESMAN NATIONAL LIFE INS. CO., THE
STERLING HEALTH PLAN
STERLING INVESTORS LIFE INSURANCE
STERLING LIFE INSURANCE COMPANY
STERLING LIFE INSURANCE COMPANY
STERLING OPTION II
STERLING OPTION II
1249-00
0440-00
0441-00
0442-00
4086-00
3568-00
4083-00
1227-00
3863-00
3686-00
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
79
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
STERLING OPTION ONE
STEVE D THOMPSON TRUCKING CO
STEWART & STEVENSON MUTUALLY PREFERRED
STEWART SANDWICHES INC
H500-60
0980-00
2687-00
1629-00
HARRISBURG
WINNSBORO
HARVEY
NORFOLK
PA
LA
LA
VA
17106
71295
70058
23502
STOLT COMEY SEAWAY
STONEBRIDGE LIFE INSURANCE
STOUFFER PINEISLE RESORT
STOWE ASSOCIATES ADMINISTRATORS
2977-00
3765-00
1861-00
2485-00
LUBBOCK
PLANO
LAKE LANIER ISLANDS
ATLANTA
TX
TX
GA
GA
79453
75075
30518
30341
STRATEGIC HEALTH CARE
STRATEGIC RESOURCE COMPANY
STRAWBERRY ASSOCIATES LTD
STUDENT ASSURANCE SERVICES, INC
STUDENT INSURANCE DIVISION
STUDENT INSURANCE INCORPORATED
STUDENT PLANS INC
SUBURBAN HEALTH CARE BENEFITS INC
2659-00
2626-00
2503-00
2980-00
1782-00
1535-00
2096-00
2761-00
DES PLAINES
COLUMBIA
VENTNOR
STILLWATER
IRVING
METAIRIE
WHEATON
FAIRFAX
IL
SC
NJ
MN
TX
LA
IL
VA
60018
29224
08406
55082
75015
70004
60189
22030
SUGAR CANE HEALTH CARE TRUST
SUMMIT AMERICA INSURANCE
0755-00
3901-00
LAFAYETTE
OVERLAND PARK
LA
KS
70598
66210
SUMMIT BANK INDPLS
SUMMIT INSURANCE PLAN TRUST (GROUP PROG,INC)
SUMMIT MEDICARE
SUMMIT NATIONAL LIFE INS. CO.
SUN HEALTHCARE GROUP
SUN LIFE ASSURANCE CO. OF CANADA
0451-00
1218-00
3800-00
0443-00
3093-00
0445-00
INDIANAPOLIS
BREAUX BRIDGE
LONDON
AKRON
ALBUQUERQUE
WELLESLEY HILLS
IN
LA
KY
OH
NM
MA
46204
70517
40742
44313
87199
02181
SUN LIFE INS. CO. OF AMERICA
0446-00
BALTIMORE
MD
21201
SUNBELT LIFE INS. CO.
SUNMARK EMPLOYEE BENEFIT TRUST
0444-00
1868-00
SHREVEPORT
LITTLE ROCK
LA
AR
71130
72211
SUNSHINE OIL AND STORAGE INC
SUNSHINE STATE HEALTH PLAN
SUPERIOR SURGICAL MANUFACTURING COMPANY
1362-00
4020-00
2012-00
DONALDSONVILLE
FARMINGTON
ST PETERSBURG
LA
MI
PA
70346
63640
33710
SUPERIOR VISION
SUPERMARKET CLAIMS
SUPERVALU INC
SUPPLEMENTAL MEDICARE WRAPAROUND
SUPPORT SYSTEMS INTERNATIONAL
SUPREME LIFE INSURANCE
SURE HEALTH INSURANCE BENEFITS
SUSQUEHANNA ADMINISTRATORS INC
SWIFT SHIPS
SXC HEALTH SOLUTIONS
SYCUAN INSURANCE SERVICES
SYMETRA LIFE INSURANCE CO
SYMETRA MEDICAL PLAN
3254-00
1623-00
2525-00
3441-00
2062-00
1959-00
3403-00
1292-00
2486-00
4084-00
2550-00
3278-00
3315-00
P O BOX 69314
P O BOX 149
1400 DESTREHAN AVE
P O BOX 12759
5232 CURLEW DR
P O BOX 53010
2700 WEST PLANO PARKWAY
9000 HOLIDAY RD
3084 MERCER UNIV DR
SUITE 210
2250 EAST DEVON AVE
P O BOX 23759
P O BOX 2428
P O BOX 196
P O BOX 152152
P O BOX 546
P O BOX 1390
3987 UNIVERSITY DR
SUITE 100
P O BOX 81189
7400 COLLGE BLVD
SUITE 100
1 INDIANA SQ #B30
P O BOX 1180
P O BOX 7808
POST OFFICE BOX 5151
P O BOX 93098
ONE SUN LIFE
EXECUTIVE PARK
SUN LIFE BUILDING
CHARLES CENTER
6001 FINANCIAL PLAZA
ONE FINANCIAL CENTRE
650 SOUTH SHACKLEFORD RD
P O DRAWER 72
P O BOX 3070
5999 CENTRAL AVENUE
STE 400
P O BOX 967
P O BOX 26099
P O BOX 10100
P O BOX 1449
P O BOX 97
3501 ML KING DR
P O BOX 15398
P O BOX 1523
P O BOX 1908
P O BOX 3163
P O BOX 21918
P O BOX 440
P O BOX 832237
RACHO CORDOVA
NEW ORLEANS
HIGH POINT
GOODLETTSVILLE
CHARLESTON
CHICAGO
PLANTATION
LANCASTER
MORGAN CITY
LISLE
EL CAJON
ASHLAND
RICHARDSON
CA
LA
NC
TN
SC
IL
FL
PA
LA
IL
CA
WA
TX
95741
70186
27261
37070
29402
60653
33318
17603
70381
60532
92021
54806
75083
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
80
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
SYNESYS
SYSCO GROUP BENEFIT PLAN
1715-00
1691-00
ATLANTA
HOUSTON
GA
TX
30337
77096
T K VALVE HEALTH PLAN
T M L GROUP BENEFITS RISK POOL
T P A OF PA
T.I. LOA INSURANCE
T.R. PAUL GROUP SERVICES INC
T.R.O.A. HEALTH PLAN
0987-00
2463-00
2292-00
2446-00
2386-00
1068-00
HAMMOND
AUSTIN
BLUEBELL
DALLAS
NEWTOWN
DES MOINES
LA
TX
PA
TX
CT
IA
70404
78768
19422
75265
06470
50398
TARA LIFE INS. CO. OF AMERICA
TARGET
0447-00
2196-00
KING OF PRUSSIA
RICHARDSON
PA
TX
19406
75083
TAYLOR-CARRAWAY INS AGENCY
TCC OF SOUTH CAROLINA
TCI OF LA.
TDI MANAGED CARE SERVICES INC (THRIFT DRUG INC)
TEAM CARE
TEAMS INC
TEAMSTER HEALTH WELFARE
TEAMSTER LOCAL #5
TEAMSTERS LOCAL SIX-THIRTY-ONE
TEAMSTERS LOCAL 270
TEAMSTERS LOCAL 639 EMPLOYEES HEALTH TRUST
TECHMED MANAGEMENT CORPORATION
1525-00
3670-00
2850-00
2838-00
2342-00
3227-00
1027-00
1418-00
3912-00
2769-00
1052-00
3022-00
BILOXI
CHARLESTON
BATON ROUGE
PITTSBURG
DES PLAINES
CORPUS CHRISTI
READING
BATON ROUGE
LAS VEGAS
NEW ORLEANS
WASHINGTON
HOUSTON
MS
SC
LA
PA
IL
TX
PA
LA
NV
LA
DC
TX
39533
29413
70821
15230
60017
78475
19612
70806
89126
70117
20018
77042
TEMPLETON ENERGY
1277-00
SHREVEPORT
LA
71101
TENET HEALTHCARE CORP
2877-00
DALLAS
TX
75243
TENET PPO DEMONSTRATION PROJECT
TENNCARE
TENNESSEE LABORERS HEALTH & WELFARE FUND
H190-10
3555-00
1774-00
KENNER
NASHVILLE
GOODLETTSVILLE
LA
TN
TN
70065
37202
37072
TENNESSEE VALLEY OPERATING ENGINEER
TERRA FIRST HEALTH
TERRA INTERNATIONAL INC
TERREBONNE PARISH GOVERNMENT
TESORO BENEFIT PLAN
TEXACO INC
TEXAS AND PACIFIC EMPLOYEES HOSP ASSOC
TEXAS CARPENTERS WELFARE FUND
3673-00
2323-00
1875-00
2275-00
0951-00
2795-00
0904-00
2624-00
GOODLETTSVILLE
CORAOPOLIS
SIOUX CITY
SHREVEPORT
SAN ANTONIO
WHITE PLAINS
MARSHALL
DALLAS
TN
PA
IA
LA
TX
NY
TX
TX
70070
15108
51101
71137
78286
10650
75670
75243
TEXAS EASTERN TRANSMISSION CORPORATION
1666-00
HOUSTON
TX
77252
TEXAS
TEXAS
TEXAS
TEXAS
2134-00
0867-00
3116-00
H451-30
4893 RIVERDALE RD SUITE
10103 FONDRAN
SUITE 500
P O DRAWER 9248
P O BOX 2015
P O BOX 1127
P O BOX 655474
P O BOX 5508
KIRKLE-VAN ORSDEL INC
400 LOCUST ST
367 SOUTH GULPH ROAD
CONTROL DATA POBOX 833823
DEPT 198
P O BOX 1459
P O BOX 22557
5304 FLORIDA BLVD
P. O. BOX 2860
P O BOX 5116
711 N CARANCAHUA
P O BOX 15224
1772 DALLAS DR
P O BOX 26509
701 ELYSIAN FIELDS AVE
3130 AMES PL NE
10370 RICHOND
SUITE 950
509 MARKET
500 U.M.B.BLDG
9535 FOREST LANE
SUITE 110
200 W ESPLANADE
P O BOX 20007
907 TWO MILE PKWY
SUITE C-5
P O BOX 1449
POST OFFICE BOX 2500
600 FOURTH ST
P O BOX 70100
8700 TESORO DRIVE
2000 WESTCHESTER AVENUE
304 UNIVERSITY
12160 ABRAMS FUND
SUITE 211
EMPLOYEE INSURANCE
P O BOX 2521
P O 630009
PO BOX 1160
P O BOX 15645
44 VANTAGE WAY
SUITE 300
P O BOX 42813
NACOGDOCHES
OWENSBORRO
LAS VEGAS
NASHVILLE
TX
KY
NV
TN
75963
42301
89114
37228
HOUSTON
TX
77242
FARM PRODUCTS
GAS TRANSMISSION CORP
HEALTH CHOICE
HEALTHSPRING
TEXAS IMPERIAL LIFE INS. CO.
3000-00
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
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TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
TEXAS INTERNATIONAL LIFE INSURANCE
TEXAS INVESTORS LIFE INSURANCE CO
TEXAS LIFE INS. CO.
TEXAS MUNICIPAL GROUP BENEFITS RISK POOL
TEXAS NATIONAL GROUP ADMINISTRATORS,INC.
TEXAS PIPE TRADES BENEFIT PLAN
TEXAS TRUE CHOICE
TEXTRON
3406-00
1468-00
0448-00
2306-00
1043-00
1778-00
3484-00
2748-00
WINSTON-SALEM
AUSTIN
WACO
AUSTIN
HOUSTON
DALLAS
PLANO
WILMINGTON
NC
TX
TX
TX
TX
TX
TX
MA
27116
78759
76703
78768
77282
75240
75025
01887
THE
THE
THE
THE
THE
THE
THE
THE
THE
ALLEN J. FLOOD COMPANIES INC
AMERICAN MILITARY SOCIETY INSURANCE PLANS
AMERICAN WORKER
BENEFIT GROUP
BENEFITS FOUNDATION
BRAND COMPANIES INC
BUSINESSMEN'S & EMPLOYEES SECURITY TRUST
CHAPMAN PRINTING CO., INC
DEACONESS HEALTH SERVICES CORP.
2461-00
2289-00
3775-00
2652-00
1641-00
2135-00
1645-00
2575-00
1565-00
LARCHMONT
NEVERSINK
INDIANAPOLIS
OMAHA
RICHARDSON
WESTCHESTER
ATLANTA
HUNTINGTON
ST LOUIS
NY
NY
IN
NE
TX
IL
GA
WV
MO
10538
12765
46220
68144
75083
60154
30341
25728
63127
THE
THE
THE
THE
THE
EMPLOYERS PLAN GRP INSURANCE ADMINISTRATORS
GUARDIAN
HARTFORD INSURANCE CO
HEALTH EXCHANGE
HILLHAVEN CORP
1430-00
3635-00
1063-00
3884-00
1171-00
P O BOX 11007
8140 MOPAC EXPRESSWAY
POST OFFICE BOX 830
P O BOX 2015
PO BOX 820929
13601 PESTON RD
P O BOX 250089
NATIONAL RX SERVICES
500 RESEARCH DR
TWO MADISON AVE
P O BOX 606
P O BOX 20765
11725 ARBOR ST
P O BOX 831151
5 WESTBROOK CORP CENTER
12 PERIMETER PARK STE 115
P O BOX 2968
PENSION ASSOC INC
3701 S LINDBERGH
P O BBOX 88572
P O BOX 8019
P O BOX 29164
P O BOX 165750
BENEFITS DEPT
CALLER SERVICE 2264
GROUP EMPLOYEE BENEFIT FU
P O BOX 1819
10E FIGUEROA ST
P O BOX 924404
401 NORTH EXECUTIVE DR
P O BOX2650
25145 COUNTRY CLUB BLVD
3616 SOUTH I10 SERVICE RD
P O BOX 8570
111 VETERANS BLVD
SUITE 500
10101 LINN STATION RD
SUITE 870
P O BOX 83179
P O BOX 40
14111 SCOTTSLAWN AVE
DEPT SM UNITED MED RESO
P O BOX 145801
2200 MEMORIAL DR
ALEXANDRIA
P O BOX 862
P O BOX 660145
P O BOX 850
FIRST CONTINENTAL INC CO
P O BOX 3101
LEE JARMON FORD
P O BOX 110098
ATLANTA
APPLETON
SHAWNEE MISSION
KANSAS CITY
TACOMA
GA
WI
KS
MO
WA
30338
54912
66201
64116
98401
JACKSON
MS
39215
SANTA BARBARA
HOUSTON
BROOKFIELD
WACO
NORTH OLMSTED
METAIRIE
CA
TX
WI
TX
OH
LA
93101
77292
53005
76702
44070
70011
METAIRIE
LA
70005
LOUISVILLE
KY
40223
BATON ROUGE
MINNEAPOLIS
MARYSVILLE
CINCINNATI
LA
MN
OH
OH
70884
55440
43041
45250
LA
71301
SEATTLE
DALLAS
VOORHEES
LITTLE ROCK
WA
TX
NJ
AR
98111
75266
08043
72203
CARROLLTON
TX
75011
THE IRBY COMPANIES
2987-00
THE
THE
THE
THE
THE
THE
1856-00
2710-00
1737-00
1878-00
2311-00
2401-00
LEGIONNAIRE INSURANCE TRUST
LITTLETON GROUP INSURANCE SERVICES
MUTUAL GROUP(U.S.)ASSOCIATION LIFE
NATIONAL GROUP INSURANCE CO.
NEW ENGLAND EMPLOYEE BENEFITS GROUP
NEWTON GROUP
THE OATH/SOUTHEAST MEDICAL OLLIANCE
1669-00
THE PHILIP MORRIS COMPREHENSIVE MEDICAL PLAN
2191-00
THE
THE
THE
THE
3548-00
0825-00
2860-00
2883-00
PHYSICAINAS ALLIANCE CORP
PILLSBURY COMPANY
SCOTTS CO.
SEACOR GROUP MEDICAL BENEFIT PLAN
THE SUMMIT
4036-00
THE
THE
THE
THE
2125-00
1100-00
1165-00
1766-00
TPA OF WASHINGTON
TRAVELERS GROUP INSURANCE CO
TRAVELERS INC CO
TRIAD TRUST
THE UNITED STATES LIFE INSURANCE CO
1835-00
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
82
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
THE W. J. JONES COMPANIES
THE WESTERN CO
2380-00
2252-00
LAKE SUCCESS
WACO
NY
TX
11042
76701
THE WURLITZER COMPANY (SELF-INSURED)
THIRD PARTY ADMINISTRATORS INC
1142-00
0822-00
HOLLY SPRINGS
HOUSTON
MS
TX
38635
77040
THIRD PARTY CLAIMS MANAGEMENT
THOMAS E. MCNULTY & ASSOCIATES, INC
THREE RIVERS BENEFIT CORPORATION
THRIVENT FINANCIAL FOR LUTHERANS
2170-00
0888-00
2901-00
3807-00
IRVING
BERKELY
SIOUX CITY
TX
IL
IA
WI
75015
60163
51101
54919
TICOR LIFE INS. CO.
TIDE WATER MARINE SERVICE INC
TIDELANDS LIFE INS. CO.
TIFTON ALUMINUM COMPANY (SELF-INSURED)
TILE TERRAZZO HEALTH & WELFARE INSURANCE
TIME INS. CO.
TIP TOP POULTRY INC HEALTH INS.
TIRE CENTER INC
0449-00
1365-00
0514-00
1191-00
1154-00
0450-00
2591-00
1435-00
LOS ANGELES
MORGAN CITY
FORTH WORTH
TIFTON
NEW ORLEANS
MILWAUKEE
ACWORTH
BOCA RATON
CA
LA
TX
GA
LA
WI
GA
FL
90048
70381
76113
31793
70116
53203
30101
33427
TITAN TIRE BENFIT PLAN
TLC ADMINISTRATIVE INSURANCE
TMG LIFE INSURANCE COMPANY
TML-IEBT
TODAY'S OPTIONS-PYRAMID LIFE
TODCO GROUP MEDICAL AND DENTAL PLAN
3004-00
2799-00
2827-00
3477-00
H542-10
3253-00
NATCHEZ
FREMONT
MOBILE
AUSTIN
HOUSTON
HOUSTON
MS
CA
AL
TX
TX
TX
39120
94537
36660
78714
77274
77042
TOLEDANO AGENCY INC
TOM THUMB-SELF INSURED
0878-00
2313-00
NEW ORLEANS
DALLAS
LA
TX
70119
75380
TOMA TRUST
TOMFORD INSURANCE CO
TOTAL BENEFIT SERVICES INC
TOTAL BROKER BENEFITS
TOTAL COMMUNITY ACTION
TOTAL GROUP SERVICE INC
TOTAL HEALTH BENEFITS
TOTAL PLAN SERVICES INC
TOTAL PROGRAM ADMINISTRATORS
TOTAL SAFETY US INC
TOUCHPOINT SELECT
2109-00
1882-00
1477-00
3832-00
2444-00
1910-00
3141-00
1384-00
1446-00
3262-00
3149-00
AUSTIN
CHATSWORTH
NEW ORLEANS
ST CHARLES
NEW ORLEANS
GRAND RAPIDES
NEW ORLEANS
DALLAS
RICHMOND
CLINTON
APPLETON
TX
CA
LA
IL
LA
MI
LA
TX
VA
IA
WI
78701
91311
70190
60174
70155
49501
70190
75235
23260
52733
54912
TOURO INFIRMARY (SELF-INSURED)
TOWER LIFE INSURANCE CO.
TOWN LIFE INSURANCE CO.
2474-00
2158-00
2978-00
MEMPHIS
SAN ANTONIO
SAN ANTONIO
TN
TX
TX
38187
78205
78205
TOWN OF MAMOU
TPA OF ARIZONA(TRAVELERS PLAN ADMINISTATORS)
TPA OF COLORADO
3185-00
1516-00
1907-00
MAMOU
PHOENIX
ENGLEWOOD
LA
AZ
CO
70554
85072
80112
TPA OF FLORIDA
2656-00
2001 MARCUS AVE
100 NORTH 6TH
SUITE 800
P O BOX 280
10235 W LITTLE YORK
SUITE 430
P O BOX 152880
5434 W ST. CHARLES ROAD
518 8TH ST/STE E
4321 N BALLARD RD
APPLETON
6300 WILSHIRE BLVD.
P O BOX 2407
POST OFFICE BOX 2991
P O BOX 88
1407 DECATUR ST
515 WEST WELLS STREET
P O BOX 149
SELF-INSURED
P O BOX 3940
P O BOX 927
P O BOX 7450
P O BOX 6408
P O BOX 149190
P O BOX 742568
2000 W SAM HOUSTON PKWY
STE 800
4052 ULLOA STREET
ALPHA DATA
P O BOX 803506
710 W FIFTEENTH
21032 DEVONSHIRE #202
P O BOX 30180
225 SMITH RD
1450 S JEFFERSON DAVIS
P O BOX 1687
P O BOX 30444
P O BOX 36631
P O BOX C32011
P O BOX 2920
5 INOVATION COURT
P O BOX 507
P O BOX 171823
310 S ST MARYS ST
TOWN LIFE BUILDING
3108 S ST.MARY ST
P O BOX 490
PO BOX 52100
9085 E MINERAL CIRCLE
SUITE 290
P O BOX 49408
SARASOTA
FL
34230
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
83
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
TPA OF MINNESOTA INC
1930-00
BROOKLYN CENTER
MN
55430
TPA OF TENNESSEE/TRAVELERS PLAN ADMINISTRATOR
TPA OF TEXAS(TRAVELERS PLAN ADMINISTRATOR)
1609-00
1824-00
BRENTWOOD
DALLAS
TN
TX
37027
75244
TPA OF WASHINGTON
TPA RENTAL ASSOCIATION
TRAILBLAZER HEALTH ENTERPRISES
TRANS AMERICA
TRANS AMERICAN NATURAL GAS CORP
TRANS PACIFIC LIFE INS. CO.
TRANS STATES LINES, INC
TRANSAMERICA ASSURANCE CO
2148-00
1305-00
3911-00
3671-00
1886-00
0453-00
2353-00
1087-00
SEATTLE
LUDLOW
DALLAS
FORT MILL
LAREDO
SANTA MONICA
FT SMITH
IRVINE
WA
ME
TX
SC
TX
CA
AR
CA
98104
01056
75243
29716
78040
90406
72917
92715
TRANSAMERICA LIFE
TRANSAMERICA OCCIDENTAL LIFE
TRANSAMERICA OCCIDENTAL LIFE INS. CO.
3811-00
1059-00
0452-00
SCRANTON
HOUSTON
LOS ANGELES
PA
TX
CA
18504
77270
90051
TRANSCO ENERGY
TRANSIT MANAGEMENT OF SE LA (TMSEL-SELF-INSURED)
TRANSPORT LIFE INS. CO.
TRANSPORTATION SERVICE
TRAVELERS HEALTH NETWORK-HMO
1473-00
1454-00
0454-00
2703-00
1115-00
HOUSTON
NEW ORLEANS
FORT WORTH
WILMINGTON
NEW ORLEANS
TX
LA
TX
DE
LA
77251
70113
76102
19899
70113
TRAVELERS INS CO
TRAVELERS INS. CO. OF IL, THE
1198-00
0456-00
NEW HAVEN
CHICAGO
CT
IL
06534
60606
TRAVELERS INS. CO., THE (LIFE)
TRAVELERS INSURA
TRAVELERS INSURA
TRAVELERS INSURANCE
TRAVELERS MANAGED CARE
TRAVELERS PREFERRED
TREASURE CHEST EMPLOYEE BENEFIT PLAN
TREMONT CORPORATION
TRI SHARE
TRI WEST HEALTH CARE ADMIN
TRIAD,LLC
TRIBAL HEALTH PARTNERS TPA
TRICARE
TRICARE
TRIGON ADMINISTRATORS INC
TRINITY INDUSTRIES HEALTH PLAN
TRIPLE A LOOPER TRUCKING COMPANY
TRISM BENEFITS
TRISPAN
TRISTATE BENEFIT SOLUTIONS
0455-00
1160-00
1144-00
0744-00
2241-00
1717-00
2638-00
2449-00
3118-00
2967-00
2982-00
3922-00
3338-00
3337-00
2892-00
1382-00
1842-00
2825-00
4039-00
H361-40
HARTFORD
NEW HAVEN
NEW HAVEN
NEW HAVEN
ALBANY
PITTSBURG
LAS VEGAS
HOUSTON
MINNEAPOLIS
SURFSIDE BEACH
GLASTONBURY
PHOENIX
CAMDEN
MADISON
RICHMOND
DALLAS
DOTHAN
JOPLIN
JACKSON
CINCINNATI
CT
CT
CT
CT
NY
PA
NV
TX
MN
SC
CT
AZ
SC
WI
VA
TX
AL
MO
MS
OH
06115
06534
06534
06534
12201
15230
89109
77205
55440
29587
06033
85050
29020
53708
23285
75356
36302
64802
39225
45206
TROA HEALTH PLANS
2996-00
DES MOINES
IA
50306
TRS-CARE
1564-00
6160 SUMMIT DR
SUITE 360
5214 MARYLAND WY STE 207
4020 MCEWEN DR
SUITE 280
800 5TH AVE
BOX N
8330 LBJ FREEWAY
P O BOX 1279
1420 CEDAR AVE
3130 WILSHIRE BLVD.
P O BOX 17011
2102 BUSINESS CENTER DR
SUITE 115
P O BOX 97
P O BOX 7631
BOX 2101
TERMINAL ANNEX
2800 POST OAK BLVD
639 LOYOLA AVE/SUITE 1360
714 MAIN STREET
P O BOX 8788
639 LOYOLA AVE
STE 1320
P O BOX 9448
MADISON PLAZA
200 W. MADISON STREET
ONE TOWER SQUARE
P O BOX 9448
P O BOX 9448
P O BOX 9448
P O BOX 22026
P O BOX 1509
2950 SOUTH INDUSTRIAL RD
P O BOX 62107
P O BOX 1181
P O BOX 870026
95 GLASTONBURY
P O BOX 71490
P O BOX 7031
P O BOX 7890
P O BOX 85639
P O BOX 569640
P O BOX 6827
P O BOX 88
P O BOX 23046
619 OAK ST
1ST FLOOR
ATTN: CLAIMS
P O BOX 9126
P O BOX 28902
SAN ANTONIO
TX
60054
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
84
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
TRUCK MAINTENANCE INC EMPLOYEE BENEFITS
TRUCKER'S ADMINISTRATOR'S
TRUE CHOICE USA
TRUMAN NATIONAL LIFE INS. CO.
1398-00
0940-00
3627-00
0457-00
PORT ALLEN
CHARLOTTE
PLANO
NORTH KANSAS CITY
LA
NC
TX
MO
70767
28226
75025
64116
TRUSTED PLANS
TRUSTEES OF IBEW LOCAL #1579
3461-00
1258-00
TACOMA
AUGUSTA
WA
GA
98401
30901
TRUSTEES OF MAJOR LEAGUE BASEBALL PLAYERS BENEFIT
TRUSTEES OF THE GILAIA FUND
TRUSTEES,LABORERS INTNATL UNION OF N AMERICA
2554-00
1779-00
1591-00
CLEVELAND
BATON ROUGE
NEWBURGH
OH
LA
NY
44114
70825
12550
TRUSTMARK INSURANCE CO
TRUSTMARK INSURANCE CO
TRUSTMARK LIFE INSURANCE CO
TRY CO ADMINISTRATIVE SERVICES INC
2502-00
3095-00
3651-00
1801-00
BOARDMAN
LAKE CHARLES
CLINTON
BELLAIRE
OH
LA
IA
TX
44513
70615
52733
77402
TUBOSCOPE INC
TUCKER & CLARK INC
TUFTS HEALTH PLAN
TULANE PREFERRED HEALTH PLAN, PLAN #50119
1962-00
1120-00
3256-00
2149-00
HOUSTON
DALLAS
WATERTOWN
NEW ORLEANS
TX
TX
MA
LA
77001
75380
02471
70112
TULANE UNIV STD/DEPND ACCIDENT,SICK.INS.PLAN
TURNER CONSTRUCTION GROUP
TUTHILL CORPORATION HEALTH CARE PLAN
2296-00
2529-00
2985-00
NEW ORLEANS
BATON ROUGE
TICKFAW
LA
LA
LA
70118
70821
70466
TYSON FOOD-CIGNA HEALTH
U H C MANAGEMENT CO. INC
U S AIRWAYS INC HEALTH PLAN
1694-00
2603-00
0032-47
CHATTANOOGA
MINNEAPOLIS
VOORHESS
TN
MN
NJ
37422
55440
08043
U S HEALTH CARE
U S MILITARY MEDICAL CARE
U.S. AMERICA INSURANCE ADMINISTRATORS INC
U.S. BENEFITS
U.S. DEPT OF LABOR
U.S. FIRE INS
U.S. LIFE INSURANCE CO
U.S. SHOE HEALTHCARE PROTECTION PLAN
UASB ASSOCIATION INSURED BENEFITS
UCIP PROGRAM
UF & CW INTERNATIONAL LOCAL UNION
UFCW LOCAL 1459
UFCW SOUTHERN CALIFORNIA
UHC INTEREST PAYMENTS
UMR
UMR
UMR
UMR
UMWA HEALTH ABND RETIREMENT FUNDS
UNDERWRITERS INSURANCE CO
UNDERWRITERS NATIONAL ASSURANCE CO.
2811-00
0881-00
1841-00
2781-00
2216-00
1908-00
1974-00
1873-00
3472-00
2383-00
1806-00
3351-00
3937-00
INT9-94
3658-00
3655-00
3617-00
3613-00
1096-00
1187-00
0460-00
624 HWY 190W
7415 PINEVILLE MATTHEWS R
P O BOX 251389
SUITE 302
2800 ROCKCREEK PARKWAY
P O BOX 1894
HEALTH & WELFARE FUND
1250 REYNOLDS ST
1375 E NINTH ST/STE 2600
ONE AMERICAN PLACE ST2020
LOC #17 HLTH BENEFIT FUND
305B LITTLE BRITAIN RD
P O BOX 9055
3000 HWY 90 EAST SUITE 1
P O BOX 2942
531 BELLAIRE BLVD
BOX 539
POST OFFICE BOX 808
P O BOX 802516
P O BOX 9185
TULANE MED CTR HOSPITAL
PAN-AMERICAN LIFE INS CO
TULANE UNIV HEALTH CENTER
P O BOX 2750
MANUFACTURING ADMIN ASST
P O BOX 400
P O BOX 118023
9900 BREN ROAD EAST
4 ECHELON PLAZA
201 LAUREL ST
P O BOX 2177
P O BOX 7927
P O BOX GA
P O BOX 13190
P O BOX 6000
P O BOX 226836
P O BOX 36128
P O BOX 3038
P O BOX 1581 MSN 2E
P O BOX 3048
7417 NORTH PETER
P O BOX 61593
6425 KATELLA AVE
3838 N CAUSEWAY/STE 2600
P O BOX 2838
P O BOX 690450
P O BOX 30541
BOX 30541
2021 K STREET NW
6210 CAMPBELL RD
3637 N MERIDIAN ST
MIDDLETOWN
MADISON
CARONA DEL MAR
PORTLAND
DUNCAN
DALLAS
DALLAS
CINCINNATI
NEPTUNE
NAPERVILLE
ARABI
KING OF PRUSSIA
CYPRESS
METAIRIE
CLINTON
SAN ANTONIO
SALT LAKE CITY
SALT LAKE CITY
WASHINGTON
DALLAS
INDIANAPOLIS
CT
WI
CA
OR
OK
TX
TX
OH
NJ
IL
LA
PA
CA
LA
IA
TX
UT
UT
DC
TX
IN
06457
53707
92625
92713
73534
75221
75234
45201
07754
60566
70032
19406
90630
70002
52733
78269
84130
84130
20006
75248
46208
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
85
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
UNI FLEX
2842-00
SPARKS
NV
89434
UNIATED BEHAVIORAL HEALTH
UNICA
UNICARE
UNICARE INSURANCE CO
UNICARE LIFE AND HEALTH
UNICARE SECURITY CHOICE-LA
UNIDTED HEALTH CARE INC/AFFILIATES
UNIFIED GROUP SERVICES
UNIFIED LIFE INSURANCE COMPANY
UNIFORM MEDICAL AND DENTAL PLAN
UNILIFE INSURANCE COMPANY
UNION BANKERS INS. CO.
UNION BENEFIT LIFE INS
UNION CENTRAL LIFE INS. CO., THE
UNION FIDELITY LIFE INS. CO.
UNION HEALTH NETWORK FOR LOCAL 406
UNION LABOR LIFE INS. CO., THE
UNION LIFE INS. CO.
UNION MUTUAL INS CO
UNION MUTUAL STOCK LIFE INS OF PORTLAND, MAINE
UNION NATIONAL LIFE INS. CO.
UNION PACIFIC RAILROAD EMPLOYEES HEALTH SYSTEM
UNION SECURITY LIFE INS. CO.
UNISON MEDICARE ADVANTAGE
UNISYS (SELF-INSURED)
UNITE HERE HEALTH
UNITED AGENTS LIFE INS CO OF AMERICA
UNITED AGRI PRODUCTS & IT'S AFFILATED CO
UNITED AMERICAN
UNITED AMERICAN INS. CO.
UNITED ASSOCIATION HEALTH & WELFARE FUND
UNITED BEHAVIOAL HEALTH
UNITED BENEFIT INSURANCE COMPANY
UNITED BRANDS CO HEALTH CARE
UNITED CHAMBERS INX
UNITED COMMERCIAL TRAVELERS
3638-00
2858-00
3341-00
2832-00
3426-00
H054-00
3556-00
3058-00
3578-00
2655-00
1840-00
0461-00
1616-00
0462-00
0463-00
1825-00
0464-00
0465-00
1844-00
1549-00
0468-00
3144-00
0469-00
H392-00
2065-00
3999-00
0939-00
2163-00
H131-00
0470-00
0790-00
3869-00
0831-00
0734-00
1777-00
2727-00
SALT LAKE CITY
AUSTIN
WOODLAND HILLS
RICHARDSON
CHICAGO
SAN ANTONIO
MINETONKA
PENDLETON
OVERLAND PARK
SEATTLE
SAN ANTONIO
DALLAS
ROCKFORD
CINCINNATI
TREVOSE
NEW ORLEANS
WASHINGTON
LITTLE ROCK
PORTLAND
BATON ROUGE
BATON ROUGE
SALT LAKE CITY
ATLANTA
MONROEVILLE
SALT LAKE CITY
AURORA
ARLINGTON
CHARLESTON
MCKINNEY
MCKINNEY
BATON ROUGE
SALT LAKE CITY
OMAHA
NEW YORK
NAPERVILLE
COLUMBUS
UT
TX
CA
TX
IL
TX
MN
IN
KS
WA
TX
TX
IL
OH
PA
LA
DC
AR
OR
LA
LA
UT
GA
PA
UT
IL
TX
WV
TX
TX
LA
UT
NE
NY
IL
OH
84130
78714
91367
75081
60680
78279
55343
46064
66225
98124
78265
75226
61105
45201
19049
70126
20001
72203
04124
70821
70821
84103
30302
15146
84130
60598
76011
25332
75070
75070
70805
84130
68102
10020
60566
43215
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
2706-00
0471-00
2997-00
1617-00
0472-00
0473-00
0474-00
0475-00
1452-00
1146-00
2345 E PRATER WAY
#210
P O BOX 30755
P O BOX 149160
2155 OXNARD ST
P O BOX 833933
P O BOX 4458
P O BOX 795180
9900 BREN RD
P O BOX 10
P O BOX 25326
P O BOX 34850
P O BOX 47509
BOX 5433
P O BOX 357
BOX 179
4850 STREET ROAD
7370 CHEF MENTERUR HWY
111 MASSACHUSETTS AVE N W
POST OFFICE BOX 3101
P O BOX 9395
P O BOX 1042
POST OFFICE BOX 2348
795 NORTH 400 WEST
POST OFFICE BOX 50355
P O BOX 1138
P O BOX 30995
PO BOX 6020
1112 COPELAND
P O BOX 3262
P O BOX 8080
P O BOX 8080
5635 GREENWELL ST
P O BOX 30602
ONE CENTRAL PARK PLAZA
1271 AVE OF THE AMERICAS
P O BOX 3048
632 N PARK ST
P O BOX 159019
P O BOX 15093
POST OFFICE BOX 1591
P O BOX 69421
1529 NEWTON ST
8324 SKOKIE BLVD.
220 N. W. 10TH STREET
POST OFFICE BOX 2204
POST OFFICE BOX 1778
2350 EAST DEVON AVE
4200 S I-10 SERVICE RD W
SUITE 134
5900 MOSTELLER DRIVE
ALBANY
BATON ROUGE
HARRISBURG
NEW ORLEANS
SKOKIE
OKLAHOMA CITY
ATLANTA
FORTH WORTH
DES PLAINES
METAIRIE
NY
LA
PA
LA
IL
OK
GA
TX
IL
LA
12212
70821
17106
70114
60077
73103
30371
76101
60018
70001
OKLAHOMA CITY
OK
73112
COMMUNITY INSURANCE CO
COMPANIES LIFE INS. CO.
CONCORDIA COMPANIES INC
CONSUMERS HEALTH CARE ASSOC
EQUITABLE LIFE INS. CO.
EQUITY LIFE INS. CO.
FAMILY LIFE INS. CO.
FIDELITY LIFE INS. CO.
FIRE INSURANCE COMPANY
FOOD & COMMERCIAL WORKERS UNION
UNITED FOUNDERS LIFE INS. CO.
0476-00
LAM1R032
RUN: 09/24/16 07:28:56
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DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
86
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
UNITED
UNITED
UNITED
UNITED
FUNERAL SERVICES
FURNITURE WORKERS INSURANCE FUND
GENERAL LIFE INS. CO.
GROUP PROGRAMS INC
2440-00
2203-00
0477-00
3466-00
NEW ORLEANS
NASHVILLE
DALLAS
BOCA RATON
LA
TN
TX
FL
70122
37224
75221
33431
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
HEALTCARE INTERNATIONAL
HEALTH AND LIFE
HEALTH CARE
HEALTH CARE
HEALTH CARE
HEALTH CARE
HEALTH CARE
HEALTH CARE
3910-00
3782-00
H094-01
H094-00
3469-00
3606-00
3552-00
3485-00
ATLANTA
NORMAN
SALT LAKE CITY
SALT CITY
EL PASO
HARTFORD
SAN ANTONIO
CHICAGO
GA
OK
UT
UT
TX
CT
TX
IL
30374
73070
84130
84131
79998
06115
78265
60656
UNITED
UNITED
UNITED
UNITED
HEALTH
HEALTH
HEALTH
HEALTH
2705-00
H472-00
3630-00
3480-00
ATLANTA
SALT LAKE CITY
LAWRENCEVILLE
PLANO
GA
UT
IL
TX
30374
84131
62439
75024
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
HEALTH CARE OF FL MEDICARE
HEALTH CARE/DEFINITY
HEALTH GROUP
HEALTH INSURANCE
HEALTH INTEGRATED SERVICES
HEALTH ONE
HEALTH PLAN
HEALTHCARE
HEALTHCARE
HEALTHCARE
HEALTHCARE
HEALTHCARE
HEALTHCARE
HEALTHCARE
HEALTHCARE
HEALTHCARE (AZ PHYSICIANS)
HEALTHCARE (MENTAL HEALTH)
HEALTHCARE (RIVER VALLEY)
HEALTHCARE DENTAL CLAIMS
HEALTHCARE INSURANCE CO
HEALTHCARE MEDICARE SOLUTION
HEALTHCARE OF EXFORD
HEALTHCARE OF LOUISIANA
H901-10
3431-00
4130-00
3562-00
3938-00
3996-00
1949-00
1851-00
2802-00
3700-00
3987-00
3864-00
4071-00
4055-00
H392-10
H032-10
3710-00
3968-00
3834-00
3564-00
4124-00
3885-00
9999-94
SUNRISE
ATLANTA
MINNEAPOLIS
SALT LAKE CITY
SALT LAKE CITY
GARDEN CITY
INGLEWOOD
SALT LAKE CITY
SALT LAKE CITY
LEXINGTON
SALT LAKE CITY
SALT LAKE CITY
SALT LAKE CITY
DULUTH
SALT LAKE CITY
PHOENIX
LATHAM
KINGSTON
SALT LAKE CITY
DALLAS
SALT LAKE CITY
BRIDGEPORT
METAIRIE
FL
GA
MN
UT
UT
NY
CA
UT
UT
KY
UT
UT
UT
MN
UT
AZ
NY
NY
UT
TX
UT
CT
LA
33323
30374
55440
84130
84130
11530
90303
84130
84130
40512
84131
84130
84131
55816
84130
85013
12110
12402
84130
75380
84130
06601
70002
UNITED
UNITED
UNITED
UNITED
HEALTHCARE
HEALTHCARE
HMO CHOICE
INDUSTRIAL
3559-00
3909-00
H090-00
1658-00
3245 GENTILLY BLVD
P O BOX 100037
POST OFFICE BOX 1080
2500 NORTH MILITARY TRAIL
STE 450
P O BOX 740372
P O BOX 721324
P O BOX 30995
P O BOX 31362
P O BOX 981502
450 COLUMBUS BLVD
P O BOX 659429
5505 CUMBERLAND AVE
STE 307
P O BOX 740800
P O BOX 31353
712 ELEVENTH ST
5800 GRANITE PARKWAY
SUITE 900
13621 N W 12TH ST
P O BOX 740810
P O BOX 1459
P O BOX 30985
P O BOX 30783
P O BOX 9306
3405 IMPERIAL HIGHWAY
P O BOX 30555
P O BOX 30557
P O BOX 14711
P O BOX 31341
P O BOX 30978
P O BOX 31362
P O BOX 169075
P O BOX 30555
3141 NORTH THIRD AVENUE
P O BOX 1290
P O BOX 5230
P O BOX 30567
P O BOX 809027
P O BOX 30436
P O BOX 7082
3838 N CAUSEWAY BLVD
STE 2600
9900 BREN RD
P O BOX 809025
P O BOX 809025
WELFARE PLAN
5201 AUTH WAY
HOME OFFICE
ONE EAST WACKER DR
POST OFFICE BOX 11365
MINNETONKA
DALLAS
DALLAS
CAMP SPRINGS
MN
TX
TX
MD
55343
75380
75380
20746
CHICAGO
IL
60601
BIRMINGHAM
AL
35202
CARE
CARE (SECURE DIRECT)
CARE CHOICE PLUS
CARE INSURANCE CO
SRVCS/AFFILIATES
STUDENT RESOURCES
SELECT
WORKERS OF NORTH AMERICA
UNITED INS CO OF AMERICA
0516-01
UNITED INS. CO. OF AMERICA
0516-00
LAM1R032
RUN: 09/24/16 07:28:56
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DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
87
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
INSURANCE CO
INSURANCE COMPANIES INC
LIBERTY LIFE INS. CO.
LIFE AND ACCIDENT INS. CO.
LIFE INSURANCE COMPANY
LIFE INSURANCE COMPANY
MEDICAL RESOURCES
1734-00
2181-00
0478-00
0479-00
1827-00
2914-00
3352-00
ALEXANDRIA
OKLAHOMA CITY
CINCINNATI
CONCORD
CEDAR RAPIDS
OVERLAND PARK
CINCINNATI
LA
OK
OH
NH
IA
KS
OH
71315
73154
45242
03301
52407
66213
45242
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
MEDICAL RESOURCES
MEDICAL RESOURCES
MEDICAL RESOURCES
MEDICAL RESOURCES
METHODIST CHURCH (SELF-INSURED)
METHODIST CHURCH OF MS.
MIDDLE TRADES ASSOCIATION
MINE WORKERS OF AMERICA
3574-00
1805-00
3990-00
3794-00
1212-00
1712-00
3367-00
1765-00
SAN ANTONIO
CINCINATTI
SALT LAKE CITY
SALT LAKE CITY
BATON ROUGE
JACKSON
PORTLAND
BIG STONE GAP
TX
OH
UT
UT
LA
MS
OR
VA
78269
45250
84130
84130
70802
39205
97213
24219
UNITED
UNITED
UNITED
UNITED
UNITED
MINE WORKERS OF AMERICA
NATIONAL LIFE INS
OF OMAHA LIFE INS. CO.
OLYMPIC LIFE INS. CO.
PACIFIC LIFE INS. CO.
H900-91
1893-00
0480-00
1499-00
0481-00
DALLAS
NATCHEZ
OMAHA
DELAWARE
FEDERAL WAY
TX
MS
NE
OH
WA
75261
39120
68131
43015
98003
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
PARCEL SERVICES
PROVIDER SERVICES
SAVINGS LIFE INS. CO.
SECURITY LIFE INSURANCE COMPANY
SERVICE ASSN FOR HEALTHCARE
SERVICE ASSOCIATION FOR HEALTH CARE
1090-00
3155-00
0482-00
2580-00
3866-00
1545-00
NEW ORLEANS
FT WORTH
HINSDALE
JACKSON
MISSION VIEJO
DALLAS/FT WORTH ARPT
LA
TX
IL
MS
CA
TX
70123
76182
60521
39236
92690
75261
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
UNITED
SOUTHERN UNDERWRITERS
STATES FIDELITY & GUARANTY CO
STATES GUARDIAN HEALTH INSURANCE CO
STATES LIFE INS. CO. IN THE CITY OF NY, THE
STATES STEEL AND CARNEGIE FUND
TEACHERS ASSOC INS COMPANY
TEACHERS ASSOC. INS. COMPANY
TEACHERS ASSOCIATION
TRANSPORTATION UNION INSURANCE ASSOCIATION
VETERAN'S INSURANCE COMPANY
WORLD INS. CO.
1241-00
1245-00
2052-00
0483-00
1396-00
3691-00
1599-00
H133-00
2897-00
0983-00
0484-00
4129 PARLIAMENT DRIVE
P O BOX 18497
10495 MONTGOMERY ROAD
ONE GRANITE PLACE
P O BOX 73909
7201 W 129 ST/SUITE 300
5151 PFEIFFER RD
ML 400
P O BOX 690450
P O BOX 145804
P O BOX 30515
P O BOX 30533
527 NORTH BOULEVARD
P O BOX 1201
P O BOX 13250
CLOVER LEAF SQUARE
US ROUTE 23
P O OBX 619099
510 HIGHLAND BLVD
FARNAM AT 33RD STREET
P O BOX 1005
33405 8TH AVENUE SOUTH
C-3000
151 BROOKHOLLOW ESPLANADE
P O BOX 820277
901 N. ELM STREET
P O BOX 13587
P O BOX 6080-174
NATIONAL HEALTH CARE INS
POST OFFICE BOX 619999
P O DRAWER 66398
P O BOX 1186
P O BOX 152152
125 MAIDEN LANE
600 GRANT STREET
P O BOX 30010
P O BOX 26580
P O BOX 26580
14600 DETROIT AVE
NATIONAL EXECUTIVE OFFICE
ADMINISTRATIVE & SERVICE
DODGE AT 33RD
7800 MADISON ST
3316 FARNAM ST
P O BOX 30783
840 CAROLINA ST
P O BOX 39550
P O BOX 3509
1600 E HILL ST
P O BOX 700
367 SOUTH GULPH ROAD
BATON ROUGE
METAIRIE
IRVING
NEW YORK
PITTSBURGH
AUSTIN
AUSTIN
AUSTIN
CLEVELAND
TREVOSE
OMAHA
LA
LA
TX
NY
PA
TX
TX
TX
OH
PA
NE
70896
70004
75015
10038
15219
78755
78755
78755
44107
19049
68175
RIVER FOREST
OMAHA
SALT LAKE CITY
SAUK CITY
ROCHESTER
ORLANDO
SIGNAL HILL
DUNCAN
KING OF PRUSSIA
IL
NE
UT
WI
NY
FL
CA
OK
PA
60305
68175
84130
53583
14604
32802
90755
73533
19406
UNITED WORLD LIFE INSURANCE COMPANY
UNITED WORLD LIFE INSURANCE COMPANY
UNITEDHEALTH INTEGRATED SERVICES
UNITY HEALTH INSURANCE
UNIVERA
UNIVERSAL AMERICAN
UNIVERSAL CARE INC
UNIVERSAL FIDELITY INS.
UNIVERSAL HEALTH SERVICES INC
0764-00
3783-00
3873-00
3301-00
3374-00
H333-30
3381-00
0853-00
1548-00
LAM1R032
RUN: 09/24/16 07:28:56
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DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
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TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
UNIVERSAL HEALTHCARE
UNIVERSAL HEALTHCARE
H582-00
H540-40
ST PETERSBURG
ST PETERSBURG
FL
FL
33731
33701
UNIVERSAL HEALTHCARE
UNIVERSAL LIFE INS. CO.
UNIVERSAL STANDARD HEALTH CARE
UNIVERSAL UNDERWRITERS LIFE INS. CO., THE
UNIVERSITY CARE ADVANTAGE
UNIVERSITY CARE ADVANTAGE
UNR HOME PRODUCTS (SELF-INSURED)
UNUM LIFE INSURANCE CO OF AMERICA
3730-00
0485-00
2942-00
0486-00
4093-00
4047-00
2414-00
0467-00
ST PETERSBURG
MEMPHIS
SOUTHFIELD
KANSAS CITY
PHOENIX
PHOENIX
RUSTON
PORTLAND
FL
TN
MI
MO
AZ
AZ
LA
ME
33731
38105
48086
64112
85069
85069
71273
04122
UNUM MUTUAL LIFE INS. CO.
0466-00
PORTLAND
ME
04122
UPMC HEALTH PLAN
H390-70
PA
15230
UPMC HEALTH PLAN
UPSTATE ADMIN SERVICES
US ABLE LIFE
US ADMINISTRATORS
3962-00
2886-00
2201-00
0749-00
PITTSBURGH
SYRACUSE
LITTLE ROCK
LOS ANGELES
PA
NY
AR
CA
15230
13217
72203
90030
US AGENCIES CASUALTY INSURANCE CO
3304-00
BATON ROUGE
LA
70809
US CIVIL SERVICE COMMISSION BUREAU/RETIREMENT
US FAMILY HEALTH PLAN
US GUARDIAN HEALTH INS CO
USA AMERICAN
USA HEALTHCARE
USA HEALTHNET INC / FORMERLY AMER.HLTH.NETWORK INC
USA TRUCK,INC
USAA LIFE INS. CO.
USI ADMINISTRATORS/CBCA ADMINISTRATORS
USL CAMPUS INSURANCE
USLIFE CREDIT LIFE INS. CO.
USNOW
UTAH LABORERS HEALTH & WELFARE FUND
UTC (A FRATERNAL BENEFIT SOCIETY)
V.I.P. NATIONAL AUTOMOTIVE INS
0715-00
3967-00
1784-00
1982-00
3970-00
1278-00
2351-00
0458-00
3030-00
2207-00
0459-00
3353-00
3214-00
2852-00
1984-00
WASHINGTON
HOUSTON
IRVING
MIAMI
MISSION VIEJO
PHOENIX
VAN BUREN
SAN ANTONIO
SAVANNAH
LAFAYETTE
SCHAUMBURG
PLANO
SALT LAKE CITY
COLUMBUS
DALLAS
DC
TX
TX
FL
CA
AZ
AR
TX
GA
LA
IL
TX
UT
OH
TX
20044
77292
75015
33152
92690
85020
72956
78288
31416
70504
60195
75026
84119
43215
75235
VALERO CORPORATE SERVICES COMPANY
VALLEY FORGE LIFE INS. CO.
VALLEY LINE COMPANY (SEQUA)
VALLEY SYSTEMS MEDICAL ASSISTANCE PROGRAMS
VALUE BEHAVIORAL HOUSE
VALUE OPTIONS
VALUE RX
3069-00
0487-00
1918-00
2044-00
2522-00
3163-00
2142-00
SAN ANTONIO
CHICAGO
ST LOUIS
COLUMBIA
TAMPA
LATHAM
SOUTHFIELD
TX
IL
MO
MD
FL
NY
MI
78292
60685
63105
21045
33607
12110
48075
VANTAGE HEALTH PLAN INC
VANTAGE HEALTH PLAN, INC.
VARIABLE PROTECTION ADMINISTRATORS INC
VERITY HEALTHNET
2804-00
H557-60
2146-00
3307-00
P O BOX 3211
100 CENTRAL AV
SUITE 200
P O BOX 294
480 LINDEN AT WELLINGTON
P O BOX 5077
5115 OAK STREET
P O BOX 38549
P O BOX 38549
600 JONESBORO ST
FLEXIBLE BENEFITS SERVICE
2211 CONGRESS STREET
FLEXIBLE BENEFITS SERVICE
2211 CONGRESS STREET
P O BOX 2997
PITTSBURGH
P O BOX 2999
P O BOX 6589
P O BOX 1650
P O BOX 30654
TERMINAL ANNEX
8550 UNITED PLAZA BLVD
STE 805
P O BOX 14172
P O BOX 924708
P O BOX 152152
P O BOX 527750
P O BOX 6080-288
7301 N 16 STREET/STE 201
P O BOX 449
USAA BUILDING
P O BOX 16579
P O BOX 42611
ONE WOODFIELD LAKE
P O BOX 260808
2156 WEST 2200 SOUTH
P O BOX 159019
DALLAS REG CLIMS OFFICE
P O BOX 36128
P O BOX 500
CNA PLAZA
120 SOUTH CENTRAL AVE
P O BOX 338
1715 NORTH WEST SHORE 775
P O BOX 1347
22255 GREENFIELD
SUITE 550
130 DESIARD ST/STE 300
130 DESIARD ST., STE 300
6902 PEARL ROAD-SUITE 500
P O BOX 83578
MONROE
MONROE
CLEVELAND
BATON ROUGE
LA
LA
OH
LA
71201
71201
44130
70884
LAM1R032
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TP-0-32-2
PAGE:
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TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
VERMILION PARISH SHERIFF DEPART. HEALTH BENEFIT PLAN
VERNON PARISH SCHOOL BOARD
VETERANS ADMINISTRATION
VETERANS ADMINISTRATION/CHAMPVA
VETERANS LIFE INS. CO.
VETERANS OF FOREIGN WARS
VETRI SYSTEMS
VICARE ADMINISTRATIVE SERVICES
VISION INS. CO.
VISION SERVICE PLAN
VISTA MANAGEMENT
VIVA HEALTH
VIVA HEALTH ADMINISTRATION
VIVIAN INDUSTRIAL PLASTICS(SELF-INSURED)
VOLUNTARY BENEFITS INC
VOLUNTEER CAPITAL CORPORATION
VOLUNTEER STATE LIFE INS. CO.
VOYAGER LIFE INS. CO.
VRX PHARMACY SERVICES
VULCAN LIFE INS. CO.
VYTRA HEALTHCARE MANAGED SYSTEMS INC
W E WALKER STRESS INC
W.J. JONES ADMINISTRATIVE SERVICES
WABASH LIFE INS. CO.
WACKENHUT CORPORATION (SELF INSURED)
WAFFLE HOUSE PLAN
WAGGONERS TRUCKING
WAL MART BENEFITS
1797-00
2242-00
3621-00
0700-00
0488-00
1462-00
3212-00
3168-00
2862-00
3494-00
1934-00
H039-00
3592-00
1301-00
2884-00
2095-00
0489-00
0490-00
3889-00
0491-00
2944-00
1253-00
2744-00
0492-00
1311-00
1526-00
3324-00
0707-00
ABBEVILLE
LEESVILLE
FLOWOOD
NEW ORLEANS
FRAZER
KANSAS
TROY
SUFFOLK
SACRAMENTO
RANCHO CORDOVA
TALLAHASSEE
BIRMINGHAM
BIRMINGHAM
VIVIAN
BIRMINGHAM
NASHVILLE
CHATTANOOGA
JACKSONVILLE
SALT LAKE CITY
BIRMINGHAM
MELVILLE
JACKSON
LAKE SUCCESS
INDIANAPOLIS
CORAL GABLES
NORCROSS
BILLING
ROGERS
LA
LA
MS
LA
PA
MO
MI
VA
CA
CA
FL
AL
AL
LA
AL
TN
TN
FL
UT
AL
NY
MS
NY
IN
FL
GA
MT
AR
70510
71446
39232
70146
19355
64111
48007
23434
95899
95670
32312
35255
35255
71082
35283
37202
37402
32203
84109
35201
11747
39206
11042
46260
33146
30071
59104
72756
WALGREEN INSURANCE COMPANY
WALKER BENEVOLENT SOCIETY
WAREHOUSE LOCAL 570
WASHINGTON LIFE INS. CO. OF AMERICA
WASHINGTON NATIONAL INS. CO.
WASHINGTON NATIONAL INSURANCE CO
WASHINGTON NATIONAL LIFE
1207-00
1696-00
2527-00
0493-00
0519-00
0519-01
1076-00
DANVILLE
WALKER
BALTIMORE
LAFAYETTE
CARMEL
CARMELON
ABBEVILLE
IL
LA
MD
LA
IN
IN
LA
61834
70785
21226
70501
46032
46032
70510
WASHINGTON TEAMSTERS WELFARE TRUST
WASHINGTON-IDAHO CARPENTERS HEALTH
WASTE MANAGEMENT INC
WASTE MANAGEMENT OF B.R.
WASTE MANAGEMENT OF ST.TAMMANY
WATCO EMPLOYEE HEALTH CARE PLAN
WATERSTONE BENEFIT ADMINISTRATOR
2613-00
3488-00
1689-00
2373-00
2005-00
2480-00
3736-00
SEATTLE
SPOKANE
MONROE
BATON ROUGE
SLIDELL
SHAWNEE MISSION
WA
WA
LA
LA
LA
KS
OK
98102
99205
71202
70835
70469
66207
73116
WATKINS ASSOCIATED INDUSTRIES INC
WAUSAU UNDERWRITERS INS CO
WEA INSURANCE GROUP(WISCONSIN EDUCATION ASSOC)
WEB TPA
WEDGE ENERGY GROUP
WEDGE WIRELINE INC
3257-00
0989-00
3025-00
3543-00
2412-00
2212-00
P O BOX 307
201 BELVIEW ST
16 CONSOLIDATED FEE
1601 PERDIDO ST
LIBERTY PARK
BROADWAY AT 34TH STREET
P O BOX 5028
1000 COMMERCIAL LANE
P O BOX 997100
3333 QUALITY DR
2424 ALLEN RD
P O BOX 55926
P O BOX 55926
P O BOX 232
P O BOX 830626
P O BOX 24300
VOLUNTEER STATE LIFE BLDG
POST OFFICE BOX 2918
P O BOX 9780
POST OFFICE BOX 1886
395 NORTH SERVICE ROAD
P O BOX 9407
1979 MARCUS AVE
8935 N MERIDIAN ST
1500 SAN REMO AVENUE
P O BOX 6450
P O BOX 21367
922 W. WALNUT ST
SUITE A
P O BOX 4007
P O BOX 45
4200 PENNINGTON AVE
POST OFFICE BOX 3468
11815 N PENNSYLVANIA
11815 N PENNSYLVANIA
VERMILION PARISH SHERIFF
P O BOX 307
2323 E LAKE AVE EAST
P O BOX 5434
284 WAGON WHEEL RD
P O BOX 40318
P O BOX 6330
P O BOX 7965
4013 NW EXPRESSWAY
OKLAHOMA CITY
P O BOX 1738
811 NO 1ST AVE
P O BOX 7338
P O BOX 99906
P O BOX 130688
P O BOX 540069
ATLANTA
WAUSAU
MADISON
GRAPEVINE
HOUSTON
GRAND PRARIE
GA
WI
WI
TX
TX
TX
30301
54401
53707
76099
77219
75054
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
90
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
WEHCO MEDIA GROUP BENEFITS
WELBORN HMO
WELL POINT HEALTH NETWORKS INC
WELL TECH. INC
WELLCARE
WELLCARE
WELLCARE
WELLCARE
WELLCARE HEALTH INS. OF ARIZONA
WELLCARE HEALTH PLANS
WELLCARE OF LA
WELLCARE OF LOUISIANA
WELLDYNE RX
WELLNET HEALTH
2221-00
2479-00
2868-00
1927-00
3586-00
3599-00
H649-90
H190-30
H134-00
3587-00
3283-00
H103-20
4111-00
4118-00
LITTLE ROCK
EVANSVILLE
WOODLAND HILLS
HOUSTON
SCRANTON
SCRANTON
SCRANTON
TAMPA
TAMPA
TAMPA
TAMPA
TAMPA
ENGLEWOOD
MESA
AR
IN
CA
TX
PA
PA
PA
FL
FL
FL
FL
FL
CO
AZ
72221
47712
91365
77002
18505
18505
18505
33622
33634
33622
33631
33631
80155
85204
WELLNET HEALTH INSURANCE
4120-00
MESA
AZ
85204
WELLPOINT NEXT RX
WELLS FARGO
WELLSTAR HEALTH SYSTEM
WEMBLEY INDUSTRIES INC
WEMCO INC
WEST CAL. CAMERON HOSPITAL
WEST FELICIANA SCHOOL DIST
WEST JEFFERSON HOSPITAL (SELF-INSURED)
WEST LAKE GROUP EMPLOYEE HEALTH CARE PLAN
3603-00
3530-00
3008-00
0931-00
1624-00
2341-00
1417-00
2728-00
2453-00
CINCINNATI
CHARLESTON
LONDON
NEW ORLEANS
NEW ORLEANS
SULPHUR
SHREVEPORT
MARRERO
COLUMBUS
OH
WV
KY
LA
LA
LA
LA
LA
OH
45240
25322
40742
70125
70151
70664
71135
70072
43216
WEST STATES INS. CO.
WESTERN AMERICAN LIFE INSURANCE CO.
WESTERN AND SOUTHERN LIFE INS. CO., THE
WESTERN ATLAS INTERNATIONAL,INC
WESTERN CASUALTY LIFE INSURANCE COMPANY
WESTERN CATHOLIC UNION
0499-00
1054-00
0497-00
1355-00
1342-00
1040-00
PHOENIX
RICHARDSON
CINCINNATI
HOUSTON
ARLINGTON
QUINCY
AZ
TX
OH
TX
TX
IL
85016
75083
45202
77252
76011
62301
WESTERN
WESTERN
WESTERN
WESTERN
WESTERN
WESTERN
WESTERN
1597-00
0863-00
0494-00
1390-00
3541-00
1447-00
1718-00
P O BOX 8200
346 N REDBANK RD
P O BOX 4204
1000 LOUISIANA SUITE 2600
P O BOX 4438
P O BOX 4438
P O BOX 4438
P O BOX 25913
8735 HENDERSON RD #2
P O BOX 25237
P O BOX 31370
P O BOX 31372
P O BOX 4517
1910 S STAPLEY DR
SUITE 221
1910 S STAPLEY
SUITE 221
P O BOX 145433
P O BOX 608
P O BOX 7711
966 S WHITE ST
P O BOX 51119
P O BOX 2269
P O BOX 51005
1101 MEDICAL CENTER BLVD
HARRINGTON BENEFITS SER
P O BOX 16789
4808 NORTH 22ND STREET
P O BOX 832687
400 BROADWAY
P O BOX 2469
1112 COPELAND ROAD
906 WCU BLDG
510 MAINE ST
206 BLACKWELL BOX 584
1112 COPELAND ROAD
POST OFFICE BOX 1660
39 SOUTH LASALLE/STE 425
2315 STOCKTON BLVD
P O BOX 901010
4200 SOUTH I10
SERVICE RD WEST, STE 134
POST OFFICE BOX 43271
C/0 AMERICAN BENEFIT PLAN
2715 MACKEY STE 207
6601 CENTERVILLE
BUSINESS PARK
P O BOX 40018
POST OFFICE BOX 2667
P O BOX 8082
POST OFFICE BOX 2907
BLACKWELL
ARLINGTON
HOUSTON
CHICAGO
SACRAMENTO
FORT WORTH
METAIRIE
OK
TX
TX
IL
CA
TX
LA
74631
76011
77001
60603
95817
76101
70001
ST. PAUL
SHREVEPORT
MN
LA
55164
71118
CENTERVILLE
OH
45459
FRESNO
PHOENIX
FRESNO
FARGO
CA
AZ
CA
ND
93755
85002
93749
58102
FARM BUREAU
FIDELITY
GENERAL LIFE INS. CO.
GENERAL SERVICES
HEALTH ADVANTAGE
INSURANCE COMPANIES
LA. LABORERS KELLY & ASSOCIATES INC
WESTERN LIFE INS. CO.
WESTERN LOUISIANA LABORS HEALTH & WELFARE
0495-00
0703-00
WESTERN OHIO HEALTH CARE PLAN
2326-00
WESTERN
WESTERN
WESTERN
WESTERN
1652-00
0496-00
0977-00
0498-00
PLAN SERVICES
SECURITY LIFE INS. CO.
STATES ADMINISTRATORS
STATES LIFE INS. CO.
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
91
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
WESTERN UNION
0823-00
UPPER SADDLE RIVER
NJ
07458
WESTLAKE GROUP OF COMPANIES
WESTMORELAND CASUALTY COMPANY
3132-00
0849-00
DUNCAN
LATROBE
OK
PA
73534
15650
WESTPORT BENEFITS
2961-00
ST LOUIS
MO
63126
WEY CO INC
WEYERHAEUSER COMPANY
WHITE CONSOLIDATED INDUSTRIES
WHITNEY NATIONAL BANK
WHITTAKER HEALTH SERVICE
3081-00
2491-00
2131-00
1647-00
0858-00
LANSING
SEATTLE
SHREVEPORT
NEW ORLEANS
NEW ORLEANS
MI
WA
LA
LA
LA
48909
98111
71139
70130
70113
WHP
WILL CNTY & VICINITY DIST COUNCIL OF CARPENTERS
WILLAIM C BEELER & COMPANY
WILLAMETTE INDUSTRIES INC
WILLBROS GROUP MEDICAL PLAN
WILLIAMSON DICKIE MANUFACTURING CO (SELF-INSURED)
WILLIS ADMINISTRATIVE SERVICES
WILLIS CORROON ADMINISTRATIVE SERVICES
WILLIS CORROON CORP OF KANSAS
WILLIS KNIGHTEN HEALTH PLAN
1377-00
0898-00
3080-00
1547-00
3015-00
2757-00
3063-00
2963-00
2807-00
1282-00
ST PETERSBURG
JOLIET
HENDERSONVILLE
RUSTON
OKLAHOMA CITY
FORT WORTH
NASHVILLE
NASHVILLE
WICHITA
SHREVEPORT
FL
IL
TN
LA
OK
TX
TN
TN
KS
LA
33701
60435
37077
71270
73177
76101
37230
37230
67201
71130
WILLSE & ASSOCIATES INC
WILSON FOODS
WINDSOR STERLING
WINDSOR-MEDICARE EXTRA HMO
1493-00
0936-00
H341-00
3549-00
BALTIMORE
OKLAHOMA CITY
PLANO
BRENTWOOD
MD
OK
TX
TN
21202
73105
75026
37027
WINN DIXIE LA INC
WINSOR EXTRA
1379-00
H185-00
NEW ORLEANS
BRENTWOOD
LA
TN
70151
37027
WINWARD INSTITUTE INC
WISCONSIN ELECTRICAL EMPLOYEES
2872-00
3151-00
SHREVEPORT
MADISON
LA
WI
71108
53713
WISCONSIN EVANGELICA LUTHERAN SYNOD
WISCONSIN LABORER'S HEALTH FUND
3183-00
3273-00
BROOKFIELD
DEFOREST
WI
WI
53008
53532
WISCONSIN PHYSICIANS SERVICE
WITCO MEDICAL BENEFIT PLAN
WITTNER COMPANIES
WMU HEALTH AND WELFARE FUND
WOODMEN OF THE WORLD
WOODMEN OF THE WORLD
1896-00
1349-00
2433-00
2514-00
3908-00
0852-00
MADISON
GRETNA
ST. PETERSBURG
SAVANNAH
OMAHA
OMAHA
WI
LA
FL
GA
NE
NE
53708
70054
33710
31403
68103
68102
WOODSMALL BENEFITS SERVICES INC
WORCESTER HEALTH CLAIMS
WORLD ACCESS CANADA,INC
WORLD HEALTH FOUNDATION & TRUST
1811-00
2122-00
2929-00
1532-00
JOPLIN
WORCESTER
WATERLOO
BATON ROUGE
MO
MA
ON
LA
64803
01605
00000
70895
WORLD INS. CO.
0500-00
HUMAN RESOURCES DEPT
DROP2-9 ONE LAKE STREET
P O BOX 1413
1006 LIGONIER ST
P O BOX 889
9201 WATSON AVE
STE 100
P O BOX 30132
P O BOX 91059
P O BOX 9329
228 ST CHARLES AVE
639 LOYOLA AVE
SUITE 1320
100 SECOND AVE S/FLOOR 11
2112 W JEFFERSON ST
P O BOX 1439
P O BOX 1100
P O BOX 770466
P O BOX 1779
P O BOX 305154
P O BOX 305154
P O BOX 2906
EMPLOYEE BENEFIT TRUST
2600 GREENWOOD RD
1 SOUTH CALVERT ST
4545 N LINCOLN BLVD
P O BOX 269003
7100 COMMERCE WAY
SUITE 285
P O BOX 51059
7100 COMMENCE WAY
SUITE 285
2140 MIDWAY AVE
HEALTH & WELFARE PLAN
2802 COHO ST/STE 201
P O BOX 981
4633 LIUNA WAY
STE 201
P O BOX 8934
P O BOX 308
5999 CENTRAL AVE/STE 400
P O BOX 23679
P O BOX 2397
WOODMEN TOWER
1700 FARNAM STREET
P O BOX 2547
440 LINCOLN ST
P O BOX 516
P O BOX 35212
SUITE 282
WORLD INSURANCE BLDG.
OMAHA
NE
68101
LAM1R032
RUN: 09/24/16 07:28:56
LOUISIANA MEDICAID MANAGEMENT INFORMATION SYSTEMS
DEPARTMENT OF HEALTH AND HOSPITALS - MEDICAL ASSISTANCE PROGRAM
TP-0-32-2
PAGE:
92
TPL CARRIER FILE LISTING
CARRIER NAME
CARRIER
CODE
CARRIER ADDRESS-LINE 1
CARRIER ADDRESS-LINE 2
CITY
ST
ZIP
WORLD SERVICE LIFE INS. CO.
WORLD SERVICE LIFE INS. CO. OF CO
WORLDWID INSURANCE/CLAIM SERVICE
WPAS NW PLUMBERS TRUST
YEARGIN INC
YOUNG BUSINESS PEOPLE OF AMERICA
0501-00
0502-00
2010-00
3946-00
1611-00
1327-00
DENVER
FORTH WORTH
SPRINGFIELD
SEATTLE
GREENVILLE
WINSTON SALEM
CO
TX
MO
WA
SC
NC
80222
76101
65804
98124
29606
27116
ZALE CORPORATION
ZAPATA GULF MARINE CORPORATION HEALTH PLAN
ZAPATA PROTEIN CORP
ZEBA TRUST CLAIMS (LAYRE CORP)
ZENITH ADMINISTRATORS (LABRS OF MT)
1663-00
1687-00
1970-00
1238-00
3727-00
IRVING
HOUSTON
ABBEVILLE
HAMPTON
SPOKANE
TX
TX
LA
NH
WA
75038
77227
70511
03842
99201
ZENITH ADMINISTRATORS INC
2283-00
DALLAS
TX
75214
ZURICH AMERICAN LIFE INS. CO.
0503-00
POST OFFICE BOX 22293
POST OFFICE BOX 1876
2274 E SUNSHINE
P O BOX 34687
P O BOX 6508
P O BOX 11107
7996 NORTH POINT BLVD
905 W WALNUT HILL LANE
P O BOX 27718
P O BOX 369
DRAWER 6000
111 WEST CATALDO AV
STE 220
6162 EAST MOCKINGBIRD
SUITE 207
231 N. MARTINGALE ROAD
THE ZURICH BUILDING
SCHAUMBURG
IL
60196
TOTAL CARRIERS ON FILE :4,038